Bridging The Gap Between Patients And Providers
Summer 2010 www.rsvphealth.com
You Have More Power Than You Think! Is Your Drug Cabinet Creating Addiction?
Community Health Care Provider Profile and List.
Extended Health Care Costs That Affect Your Family. RSVP Health | www.rsvphealth.com 1
2 RSVP Health | www.rsvphealth.com
RSVP Health | www.rsvphealth.com 3
RSVP Marketing Group | rsvpmarketinggroup.com
Credits Publisher RSVP Marketing Group Executive Editors Benjamin A. Moss Rodney D. Gross, Ph.D. Kevin Russell Creative Director Production Manager Benjamin A. Moss
Change is the law of life. And those who look only to the past or present are certain to miss the future.
Writers Rodney D. Gross, Ph.D. Benjamin A. Moss Production Coordinator Kevin Russell
- John F. Kennedy
RSVP Marketing Group LLC is excited to announce its’ new division, RSVP Health. RSVP Health “bridges the gap between patients and providers” and it is “health care and wellness reserved just for you”. The “you” includes but is not limited to the following examples: doctors of all specialties (M.D.’s. DO’s, Dentist, Chiropractors, OB/GYN, Cardiologist, Psychiatrist, Family Practice, etc.), health care entities (Hospitals, Medical Groups, Surgery Centers, Home Health, Hospice, Skilled Nursing Facilities, etc.), providers of health care products (Pharmacies, Insurance Companies, etc.), wellness (Nutritional Medicine, Spa’s, Fitness Centers, etc.) and finally “you” the individual patient and or customer.
This encompasses everything from expert, firsthand knowledge of health care administration, treatment and policy (laws, regulations, credentials, reimbursements, staffing, recruitment, patient satisfaction, budgeting, technology, business development, marketing, etc.) to expert first-hand knowledge of patients, customers and businesses (insurance coverage, demographics, access, needs, workman’s compensation, pre-employment physicals, wellness checks, etc.). RSVP Health not only will ensure “return on investment” by both providers and patients/ customers, but also most importantly provide the portal to “educate & communicate” both personalized and technologically, to “bridge the gap” between them.
RSVP Marketing Group LLC combines its’ fifty five years of executive level and professional experience in marketing, business development, business administration, health care administration and cutting edge technology with its’ “Mentalities of the Market” into RSVP Health.
For more detailed information on RSVP Marketing Group LLC and RSVP Health services, please visit our websites. www.rsvpmarketinggroup.com www.rsvphealth.com
For advertising information, please contact us at: RSVP Marketing Group 124 N. Jackson St., Farmington, MO 63640 888-762-7212 info@rsvpmarketinggroup.com
RSVP Health is provided for information and education purposes and is in no way to take the place of a health care professional’s advice. Please consult a health care professional with any health related questions. Not all information within is the opinion of RSVP Marketing Group or RSVP Health. RSVP Marketing Group is not liable for any decisions made as a result of information received from RSVP Health. RSVP Health is a division of RSVP Marketing Group. www.rsvpmarketinggroup.com www.rsvphealth.com
4 RSVP Health | www.rsvphealth.com
RSVP Health | Community Health Care and Wellness Resource Guide
As a partner of RSVP Marketing Group LLC, I proudly introduce RSVP Health’s first publication, the RSVP Health Community Health Care and Wellness Resource Guide for the residents of Missouri in the following counties (in whole and part); St. Francois, Iron, Washington, Jefferson, Ste Genevieve, Perry and Madison. As a health care professional, the concept of this for our community has been a desire of mine for the past few years, but as an employed/contracted individual for health care entities, I could not do it without it coming across as biased. Now, with being a partner with RSVP Marketing Group LLC and the development of RSVP Health, I am able to fulfill this desire. Our area has never had a true, professionally created, resource guide towards health care that wasn’t made available outside the realm of health care entities doing them about themselves only or non-health care organizations doing it just at an attempt for pure profit with no substance or most importantly, no education. What you will find within these pages is true health care and wellness substance geared to you, the individual. Though there are some traditional advertisements, they are at a minimum to ensure the goal of pure educational, accessible, resources to you. The advertisers recognize and understand the vision of this resource guide and are very generous in allowing us to provide this publication both in physical print and on-line at zero cost to you. The content to include advertisement, articles, spotlights, etc; have strict instructions to keep it relevant, honest, accessible, professional and foremost, educational. I am not in to who is the best from their point of view, only with what they can provide and educate “you” on that involves their vision, services, products and ultimately, betterment of your personal well being. Inside these pages, you will see an attempt to breakdown all the health care and wellness entities and a further breakdown into their respected specialties with detailed definitions explaining them. For so long I have been asked what the difference is between some of the following examples that you will find within this publication; M.D.’s (Medical Doctors) & DO’s (Doctors of Osteopathy), Nurse Practitioners & Doctors, Ophthalmologists & Optometrist, Home Health & Hospice, Critical Access Hospitals, Board Certified Doctors & Non-Board Certified Doctors, etc. The definitions will be a combination of my expertise and those of organizations such as National Health care Organizations, Universities, Medical Dictionaries and other Health care & Wellness Experts, etc.
We made all attempts to contact those health care and wellness entities that provide service to our areas. Not everyone welcomed the concept as some. These entities will have their information listed (name, specialty and phone number) only, that is public information anyway. The ones who do have more information further understand the importance of true education, resources and relationship. Even though someone is not listed or their information not as noticeable, does it define them as being any less important. You will find these publications throughout the area in places where people congregate for example: health care & wellness waiting rooms, coffee shops, beauty shops, schools, hotels, restaurants, etc. This initial publication is yearly for the printed version and the on-line version is updated monthly/quarterly depending on the health care entities and their updated content. Furthermore, the on-line version will have direct access for you to go the respected health care and wellness entities that you find relevant. It is a great way for them and most importantly, you, to put true and updated information and education that affects your well-being. This publication is just one piece of our overall vision on the professional education and awareness side of health care and wellness. We will redefine health care and wellness grand openings, introductions and health fairs. Health Fairs will be taken to a new level that includes professional seminars, education, input, results and professionalism that are conducted by some of the same types of health care and wellness experts as you see in this publication. Even before release of this first community health and wellness resource guide in our area, other areas have contacted us to bring the same to their communities. I would like to thank all health care and wellness entities that have participated in this guide and for seeing the importance to communicate and educate you. In addition, I would like to thank my partners who make up RSVP Marketing Group LLC and their support on the importance of health care and wellness education, communication and awareness. In closing, RSVP Health will strive to bring health care and wellness education, awareness and access to you with one goal in mind, your well-being. Rodney D. Gross, Ph.D.
RSVP Health | www.rsvphealth.com 5
Urgent Care Center
Trying to navigate the world of health care? rsvpHealth.com
HSA
6 RSVP Health | www.rsvphealth.com
Table of Contents | RSVP Health
You Have More Power Than You Think.
Is Your Drug Cabinet Creating Addiction?
Page 46
Page 8
Getting To The Bottom Of Health Care Costs.
Page 19 Health Care Provider Profiles
Page 59 Page 23
Extended health care costs that affect your family.
Page 28
Alzheimer’s Disease, Neuroimaging Initiative (ADNI) Generates Promising Early Findings.
Page 36
Help Your Insurance Company Help You!
Page 38
Page 54
Health Savings Accounts.
Page 74
Health Care Providers List.
Take charge of your weight.
Page 42
Are we thankful to those who protect our country, our freedoms and us?
RSVP Health | www.rsvphealth.com 7
By Dr. Rodney Gross, Ph.D. Benjamin A. Moss
Individuals like you now more than any point in the past have the power to “empower” oneself not only in their own health and wellness but also in the understanding and definition of health care providers and entities that provide health care. The empowerment comes from knowledge one can access from things like word of mouth to searching on the web. There is so much free, professional, detailed information right at ones fingertips. This section will help define some commonly asked questions that I have experienced throughout my health care career and ones I have answered pertaining to my said responsibilities within the health care arena. This by no means is advice on medical treatment, just educational definitions, descriptions, examples, etc, to help you understand and empower yourself to take charge of your health and wellness
SPEAK UP! How to take charge of your health and wellness.
Doctors, Pharmacies, Insurance Companies, Hospitals, etc, also are realizing this and some are taking steps to build personalized relationships with their patients/customers. They are accepting things such as education, preventative medicine and resources as part of their overall care with their patients/customers. This only benefits you more along with you continuing your health and wellness knowledge. The following pages in the section are a start to your empowerment of your health and wellness. Ask questions, research the web, go to the library, spend a day at the bookstore, most of this cost little to nothing in return for the knowledge you will receive. Your health and wellness is your “Return on Investment”. 8 RSVP Health | www.rsvphealth.com
Article Contents: Who are the Health & Wellness Providers? Primary Care Doctor`s Doctors of Medicine (M.D.s) or Doctors of Osteopathic Medicine (D.O.s) Board Certified or Non-Board Certified Physician Assistants Nurse Practitioners Who are the Health & Wellness Entities? Hospitals Emergency Rooms Ambulatory Surgery Centers Urgent Care Centers Become Your Own Health & Wellness Expert
Who are the health and wellness providers? The beginning point of entry into health care is normally with a primary care provider. In a matter of fact, Primary Care is the foundation of managed care systems. They are the “gatekeeper”. Of all the questions, I have been asked, have heard and continue to hear as a Health care Executive, is around Primary Care. I believe that this section be more detailed as much as possible to help one understand the meaning of Primary Care, their specialties, their credentials and the other staff they may have carrying out some of your care.
The best definitions I liked were from the Institute of Medicine and the American Academy of Family Doctors. The Institute of Medicine defines Primary Care as “the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained relationship with patients and practicing in the context of family and community.” In addition, the American Academy of Family Doctors describes that “Primary Care is an inclusive discipline that covers health promotion and maintenance, disease prevention, counseling, patient education and treatment of acute and chronic illnesses in a variety of settings.”
RSVP Health | www.rsvphealth.com 9
Primary Care Doctors The Primary Care Doctors currently of today are viewed as the traditional family doctor of the past who treated everything. While a Primary Care Doctor is trained in a broad variety of needs, he or she is not like “Doc Baker from Little House on the Prairie, who traveled to your house or out in the field, to treat you for everything”. They have specialized training in at least one of the following specialties:
Family Practice - Generalist by training, who can provide comprehensive care for anyone without regards to gender, age or health issue. Family Practice is now a specialty within its’ self that includes a three year residency program, accreditation and certification. Being comprehensive, he or she will perform the basic functions of an internist, pediatrician and gynecologist. Thus saying this, they normally do not dive in too deeply therefore referring the patient on to the said specialists. Internal Medicine – Specializing in a wide range of non-surgical medical problems of adults and trained to look at the whole person with special emphasis on clinical skills, diagnostics and problem solving. Internists are Board Certified by the American Board of Internal Medicine following completion of a three-year 10 RSVP Health | www.rsvphealth.com
residency and passing an examination. Many further into subspecialties such as Cardiology, Endocrinology, Hematology, Infectious Disease and Oncology, to name a few. Pediatrics – Specialize in the care for children and teenagers in every stage from infancy to adulthood. They are often involved with behavioral and social as well as strictly medical issues. A residency in General Pediatrics lasts three years.
Obstetrics/Gynecology – specializing in medical and surgical care to women and has particular expertise in pregnancy, childbirth, and disorders of the reproductive system. This includes preventative care, prenatal care, detection of sexually transmitted diseases, Pap test screening, and family planning. An obstetrician is a physician who has successfully completed specialized education and training in the management of pregnancy, labor, and puerperium (the time-period directly following childbirth). A gynecologist is a physician who has a successfully completed specialized education and training in the health of the female reproductive system, including the diagnosis and treatment of disorders and diseases.
Doctors of Medicine and Doctor of Osteopathic Medicine Doctors of Medicine (M.D.s) is defined by John Hopkins University School of Medicine as follows: “Medical Doctors who receive an intensive medical education that begins with an undergraduate college degree in a subject that lays groundwork for medicine. This is followed by four years of medical education at a university-based medical school. The medical school provides a scientific and clinical orientation to health care. Doctors are taught to prevent, diagnose and treat disease and to promote overall health for their patients. Medical education emphasizes the interrelation between, teaching, research and health care. For most M.D.s, graduation from medical school marks just the halfway point of their professional education. M.D.s continue their education in residency programs, usually in hospitals, where they get hands-on training in the specialty they have chosen. Residency programs usually last from three to seven years depending on the specialty and even more years for sub-specialties. Doctors of Osteopathic Medicine (D.O.s) is defined by the American Osteopathic Association as follows: “They work in partnership with their patients considering the impact that lifestyle and community have on the health of each individual, and they work to erase barriers to good health. D.O.s are trained to look at the whole person from their first days of medical school, which means they see each person as more than a collection of body parts that may become injured or diseased. D.O.s are taught that the whole person is greater than the sum of the parts. This means that osteopathic medical students learn to integrate the patient into the health care process as a partner. They are trained to communicate with people from diverse backgrounds and they get the opportunity to practice these skills in the classroom with simulated patients. Because of this whole-person approach to medicine, approximately 60 percent of all D.O.s choose to practice in the primary care disciplines of family practice, general internal medicine, and pediatrics. Osteopathic medical students also learn the art of osteopathic manipulative medicine,
a system of hands-on techniques that help alleviate pain, restore motion and influence the body’s structure to help it function more efficiently. One key concept osteopathic medical students learn is that structure influences function. Thus, if there is a problem in one part of the body’s structure, then function in that area will also be affected. Another integral tenet of osteopathic medicine is the body’s innate ability to heal itself. Many of osteopathic medicine’s manipulative techniques are aimed at reducing or eliminating the impediments to proper structure and function so the self-healing mechanism can assume its role in restoring the person to health. The fact is that both D.O.s and M.D.s are fully qualified physicians licensed to prescribe medication and perform surgery. Is there any difference between these two kinds of physicians? Yes and no.
“The fact is that both D.O.s and M.D.s are fully qualified physicians”
Students entering both D.O. and M.D. medical colleges typically have already completed four-year bachelor’s degrees with an emphasis on scientific courses. Both D.O.s and M.D.s complete four years of basic medical education. After medical school, both D.O.s and M.D.s obtain graduate medical education through internships, residencies and fellowships. This training lasts three to eight years and prepares D.O.s and M.D.s to practice a specialty. Both D.O.s and M.D.s can choose to practice in any specialty of medicine—such as pediatrics, family medicine, psychiatry, surgery or ophthalmology. D.O.s and M.D.s must pass comparable examinations to obtain state licenses. D.O.s and M.D.s both practice in accredited and licensed health care facilities. Together, D.O.s and M.D.s enhance the state of
Both D.O.s and M.D.s complete four years of basic medical education. After medical school, both D.O.s and M.D.s obtain graduate medical education through internships, residencies and fellowships. This training lasts three to eight years and prepares D.O.s and M.D.s to practice a specialty. Both D.O.s and M.D.s can choose to practice in any specialty of medicine—such as pediatrics, family medicine, psychiatry, surgery or ophthalmology. D.O.s and M.D.s must pass comparable examinations to obtain state licenses. D.O.s and M.D.s both practice in accredited and licensed health care facilities. Together, D.O.s and M.D.s enhance the state of health care available in the U.S. D.O.s, however, belong to a separate yet equal branch of American medical care.
health care available in the U.S. D.O.s, however, belong to a separate yet equal branch of American medical care. It is the ways that D.O.s and M.D.s are different that can bring an extra dimension to your health care.”
Board Certified vs. Non-Board Certified The American Board of Medical Specialties (ABMS) is an organization comprised of 24 approved medical specialty boards. ABMS exists to assist the activities of its member boards and to provide information to the public, government and medical profession concerning issues involving specialization and verification of medical specialists’ board certification. ABMS, recognized as the “gold standard” in physician certification, believes “higher standards for physicians means better care for patients”. ABMS describes being Board Certified as “An added measure of expertise, Board Certification granted by an ABMS Member Board provides assurance of a physician’s expertise in a particular specialty and/or subspecialty of medical practice. They also add, “Since there is no requirement or need for a certified physician in a recognized specialty to hold special certification in a subspecialty of that field, the lack of a subspecialty certification
does not indicate that a physician is unqualified to practice in the subspecialty.” The twenty four recognized ABMS Board Specialties are: Allergy and Immunology (1971), Anesthesiology (1941), Colon and Rectal Surgery (1949), Dermatology (ABMS Founding Member), Emergency Medicine (1979), Family Medicine (1969), Internal Medicine (1936), Medical Genetics (1991), Neurological Surgery (1940), Nuclear Medicine (1971), Obstetrics and Gynecology (ABMS Founding Member), Ophthalmology (ABMS Founding Member), Orthopedic Surgery (1935), Otolaryngology (ABMS Founding Member), Pathology (1936), Pediatrics (1935), Physical Medicine and Rehabilitation (1947), Plastic Surgery (1941), Preventive Medicine (1949), Psychiatry and Neurology (1935), Radiology (1935), Surgery (1937), Thoracic Surgery (1971), Urology (1935) and within these are more than 120 subspecialties. American Osteopathic Association (AOA) is a member association representing more than 67,000 osteopathic physicians (D.O.s). The AOA serves as the primary certifying body for D.O.s, and is the accrediting agency for all osteopathic medical colleges and health care facilities. The AOA’s mission is to advance the philosophy and practice of osteopathic medicine by promoting RSVP Health | www.rsvphealth.com 11
“Physician board certification is a voluntary process that approximately 80% of doctors in the U.S. obtain.”
excellence in education, research, and the delivery of quality, costeffective health care within a distinct, unified profession. AOA has eighteen Approved Specialty Boards that a D.O. has achieved expertise in a medical specialty or subspecialty.* Certification by an AOA Approved Board is not a requirement to practice in a medical specialty. Doctors of Osteopathic Medicine can become AOA certified in the following areas: Anesthesiology, Dermatology, Emergency Medicine, Family Practice, Internal Medicine, Neurology & Psychiatry, Neuromuskuloskeletal Medicine, Nuclear Medicine, Obstetrics & Gynecology, Ophthalmology, Otolaryngology, Orthopedic Surgery, Pathology, Pediatrics, Physical Medicine & Rehabilitation, Preventive Medicine, Proctology, Radiology and Surgery.
Why is a physician not board certified? Certifacts On-line, an on-line resource for verifications of Physician’s Board Certifications and their explanation is the following; “Physician board certification is a voluntary process that approximately 80 percent of doctors in the U.S. obtain. A physician is licensed by the state to “practice medicine and surgery,” and medical board certification is not a requirement for licensure. Licensed physicians may practice in whatever medical disciplines interest them and can legally practice in that field of interest without obtaining a medical residency or fellowship. 12 RSVP Health | www.rsvphealth.com
Board certification, however, means that a physician’s skills and knowledge in the specialty/subspecialty has been examined and meets standardized requirements by an ABMS Member Board. Additionally, some of the surgical specialties require one or more years of experience before physicians can take their boardcertifying exams (the number of years varies according to each board). The physician in question may fit that category and may be working to satisfy the requirements for medical board certification. Most international medical graduates need to complete some required training in this country before they are able to take a particular board’s exam (if the entire postgraduate training is completed in another country). Exceptions are made and vary with each board. (Some boards may accept Canadian and/or United Kingdom residencies.” What does “Board Eligible” mean? There is only Board Certified or Non-Board Certified, in the past doctors used the term “Board Eligible” to signify their progress to obtaining Board Certification. Some physicians used it so regularly with no intentions of becoming Board Certified that its’ meaning became useless and misleading. Thus, prompting American Board of Medical Specialties (ABMS) to have the term “Board Eligible” disavowed. Now if one inquires about a particular doctor, the Board will only state one’s precise position in the certification process.
Physician Assistant educational programs usually take at least 2 years to complete for full-time students. Most programs are at schools of allied health, academic health centers, medical schools, or 4-year colleges; a few are at community colleges, are part of the military, or are at hospitals. Many accredited P.A. programs have clinical teaching affiliations with medical schools. In 2008, 142 education programs for Physician Assistants were accredited or provisionally accredited by the Accreditation Review Commission on Education for the Physician Assistant. Eighty percent, or 113, of these programs offered the option of a master’s degree, 21 of them offered a bachelor’s degree, 3 awarded associate degrees, and 5 awarded a certificate. Most applicants to P.A. educational programs already have a college degree and some health-related work experience; however, admissions requirements vary from program to program. Many P.A.s have prior experience as registered nurses, emergency medical technicians, and paramedics. P.A. education includes classroom and laboratory instruction in subjects like biochemistry, pathology, human anatomy, physiology, clinical pharmacology, clinical medicine, physical diagnosis, and medical ethics. P.A. programs also include supervised clinical training in several areas, including family medicine, internal medicine, surgery, prenatal care and gynecology, geriatrics, emergency medicine, and pediatrics. Sometimes, P.A. students serve in one or more of these areas under the supervision of a physician who are seeking to hire a P.A.
Physician Assistants (P.A.s) Physician Assistants (P.A.s) practice medicine under the supervision of physicians and surgeons. They should not be confused with medical assistants, who perform routine clinical and clerical tasks P.A.s are formally trained to provide diagnostic, therapeutic, and preventive health care services, as delegated by a physician. Working as members of a health care team, they take medical histories, examine and treat patients, order and interpret laboratory tests and x-rays, and make diagnoses. They also treat minor injuries by suturing, splinting, and casting. P.A.s record progress notes, instruct and counsel patients, and order or carry out therapy. P.A.s also may prescribe certain medications. In some establishments, a P.A. is responsible for managerial duties, such as ordering medical supplies or equipment and supervising medical technicians and assistants. Physician Assistants work under the supervision of a physician. However, P.A.s may be the principal care providers in rural or inner city clinics where a physician is present for only 1 or 2 days each week. In such cases, the P.A. confers with the supervising physician and other medical professionals as needed and as required by law. P.A.s also may make house calls or go to hospitals and nursing care facilities to check on patients, after which they report to the physician.
Nurse Practitioners More than ever are nurses are coming to the forefront of health care and the delivering of health care. Under the collaboration of a doctor, nurse practitioners have taken on many of the duties traditionally performed by doctors that includes but not limited to taking health history, performing physical exams, ordering/ performing diagnostic tests and determining & evaluating care. Depending on their collaborative doctor and the state they are practicing in, nurse practitioners can prescribe routine medications; the only exceptions may be narcotics. Nurse practitioners have master’s or post master’s degrees and many have further specialty training in fields such as adult medicine, pediatrics, family medicine, emergency medicine and or OB/GYN. Doctors, Medical Groups, Hospitals, etc, have all recognized the value of these nurse practitioners for the achieving their goals of quality and cost effective health care delivery. With being a health care CEO, some of my best achievements were accomplished with nurse practitioners. The return on investment was so great that at one particular entity, it allowed me to transform an age-old mentality that would not even recognize nurse practitioners to them leading the way in overall health care delivery and patient satisfaction. RSVP Health | www.rsvphealth.com 13
Most of us use to understand that when we went to the doctor, if our illness warranted it, we would be admitted to the “hospital”. Additionally, if we needed lab work, radiology, surgery, and any other specialized testing, we would also be sent to the hospital. Now we all know that some of the doctors have some of these services inside their practices. The mentality of “one stop shop” has furthered itself outside the walls of an all-encompassing “hospital”. Putting it plainly, you the patient/customer are demanding for better, more efficient, cost effective, accessible, health care delivery. Even doctors, laboratory companies, pharmacies, radiology/imaging centers, surgery centers, etc, are listening to lead the way in catering to your needs. This is a great step but it is highly recommended that one have an understanding of some of these entities.
Who are the Health & Wellness Entities?
provides 24-hour emergency services; have an average length-ofstay for its patients of 96 hours or less; be located more than 35 miles (or more than 15 miles in areas with mountainous terrain) from the nearest hospital or be designated by its State as a “necessary provider”. Hospitals may have no more than 25 beds. Federal law with special payments under the Medicare program established the designation. The majority were built in the 1950s by the funding of the Hill-Burton Act. In addition, most are government owned county facilities that are governed and operated by elected officials within its’ county. Hospitalist – I have included this definition under this hospital section because it is so important. Most likely, when you are admitted to a hospital, you will be admitted to a hospitalist and not your primary care doctor. Hospitalists are employed by the hospital. Some primary care doctors do not even admit their own patients any longer. This is something you should consider when seeking a new doctor or ask your current doctor if he or she pro-
Hospitals
“Most likely, when you are admitted to a hospital, you will be admitted to a hospitalist and not your primary care doctor. Hospitalists are employed by the hospital. Some primary care doctors do not even admit their own patients any longer.”
In the United States alone, there are over 6,500 hospitals with more than one million beds and like everything else in modern medicine, America’s hospital system in is a drastic state of change. Many are down sizing, merging, affiliating, integrating services and most noticeably, diversifying. They are attempting to move into a future that demands medical institutions redefine themselves. A great tool to use to determine the quality of a hospital is their accreditation by the Joint Commission on Accreditation of Health Care Organization. Though not required by some hospitals, it is the standard on how a hospital whether large or small, for profit or non-profit and Critical Access Hospitals, deliver health care. State and Federal inspections of hospitals are made public and they make them available free of charge on their websites.
For Profit Hospitals - are investor-owned hospitals that were established particularly in the United States during the late twentieth century. In contrast to the traditional and more common non-profit hospitals, they attempt to gain a profit for their shareholders. Non-Profit Hospitals - are hospitals that organizes as a nonprofit corporation. Based on their charitable purpose and most often affiliated with a religious denomination they are a traditional means of delivering medical care in the United States. Non-profit hospitals are distinct from government owned public hospitals and privately owned for-profit hospitals. Critical Access Hospitals - a hospital located in a remote rural area; 14 RSVP Health | www.rsvphealth.com
vides continuity of care for you once you are admitted to a hospital as an inpatient. As defined by the Society of Hospital Medicine, “Hospitalists are physicians who specialize in the practice of hospital medicine. Following medical school, hospitalists typically undergo residency training in general internal medicine, general pediatrics, or family practice, but may also receive training in other medical disciplines. Some hospitalists undergo additional post residency training specifically focused on hospital medicine, or acquire other indicators of expertise in the field, such as the Society of Hospital Medicine’s Fellowship in Hospital Medicine (FHM) or the American Board of Internal Medicine’s Recognition of Focused Practice in Hospital Medicine.” If you know you are going to be admitted, ask the hospitals who are their hospitalist and their credentials and remember that hospitalist can be Physician Assistants and or Nurse Practitioners. In addition, as I mentioned above, ask your primary care provider if they admit and retain overall continuity of care of their patients or do they leave it up to the hospital’s hospitalists.
Emergency Rooms Emergency Rooms (ERs) exist only to deal with medical emergencies. Unless your situation is life threatening, you will be triaged (a system that determines the order in which patients are seen and treated) by a nurse. It is not a first come, first serve system, but a need-based system. If you have a serious or life-threatening condition, you will been seen quickly. The seriousness of the condition will not be defined by you, but by the nurse. As we all know, if your condition is otherwise, you will be waiting for quite a while. Unfortunately, many people use emergency rooms for their primary health care needs. Many reputable studies throughout the 1990s found that about 55% of emergency room visits were for nonurgent situations and that people came to the ER more frequently for coughs and sore throats than they did for chest pains. With the rising costs of health care insurance and the economy (loss of jobs), these visits rose to almost 65%. The main reason that these people utilize ERs as their primary health care is that no one can be turned away, it is federal law. Some hospitals that employ doctors experience patients that have been turned away from their doctor’s office because of past bills and no insurance, do a u-turn from the doctor’s office and walk down to the ER. What you may know or may not is that hospital charges for ER visits are normally about three times higher than what the same service would cost in a doctor’s office. Some health insurance companies have now made it difficult to get reimbursement for emergency room care that is deemed “not medically necessary”. It is not my intention to validate any political party’s stance on health care reform, just provide basic facts from someone with health care experience.
Ambulatory Surgery Centers Ambulatory Surgery Centers (ASC), also known as Outpatient Surgery Center or Same Day Surgery Center, is a health care facility that specializes in providing surgery, pain management and certain diagnostic (e.g., colonoscopy) services in an outpatient setting.
“A great tool to use to determine the quality of a hospital is their accreditation by the Joint Commission on Accreditation of Health Care Organization. Though not required by some hospitals, it is the standard on how a hospital whether large or small, for profit or non-profit and Critical Access Hospitals, deliver health care. Research your health care entities online.”
Overall, the services provided can be generally called procedures. In simple terms, qualified procedures can be considered procedures that are more intensive than those done in the average doctor’s office but not so intensive as to require a hospital stay. An ambulatory surgery center and a specialty hospital often provide similar facilities and support similar types of procedures. The specialty hospital may provide the same procedures or slightly ones that are more complex and the specialty hospital will often allow an overnight stay. Ambulatory surgery centers do not provide emergency services. In the United States, over six million surgeries a year are performed in over 4,000 ASCs. ASCs are in all 50 states and can be found throughout the world. In the US, most are licensed, certified by Medicare and accredited by one of the major health care accrediting organizations. Procedures’ performed in surgery centers are broad in scope. Many knee, shoulder, eye, and other surgeries are currently performed in ambulatory surgery centers. Some heart procedures are even taking place in certain ASCs. In the United States today, over 50% of Colonoscopy services are performed in ambulatory surgery centers. Ambulatory surgery centers rarely have a single owner. Physicians’ partners who perform surgeries in the center will often own a small part of the facility. A 1% or less ownership might be common, but percentages can vary considerably. Occasionally, a surgery center is entirely physician-owned. However, it is most common for development/management companies to own a percentage of the center. Although complications are very rare, ASCs are required by Medicare and the accreditation organizations to have a backup plan for transfer of patients to a hospital if the need arises. The three main accreditors of ASCs are the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), Accreditation Association for Ambulatory Health Care (Accreditation Association or AAAHC) and Joint Commission.
Here’s a few sites to help you get the best health care and stay informed. http://www.jointcommission.org/ http://www.ahrq.gov/consumer/ qualguid.pdf http://www.ucaoa.org/ http://www.hhs.gov/ http://www.aha.org
RSVP Health | www.rsvphealth.com 15
Urgent Care Center A new way of accessing medical care when you want it, where you want it without having to wait for an appointment to be seen, Urgent Care Centers were pioneered by ER physicians as a way to meet the demands of patients seeking an alternative to overcrowded hospital based ER’s that were geared mainly to see the trauma and the gunshot wound patient far more expeditiously than the patient with a backache. The care provided at an Urgent Care is typically just that - Urgent Care can be considered”Stat” Care. Most urgent care facilities will provide a high quality of “STAT” or immediate care within a half-hour of the patient showing up at the door. They will also accept patients who do not have health insurance coverage. This ‘immediate’ and ‘on-demand’ delivery of ambulatory care in a facility dedicated to the delivery of medical care outside of a hospital emergency department, usually on an unscheduled, walk-in basis defines the urgent care movement in the US. Most Insurance plans will cover an Urgent Care visit as long as the facility is on their roster of approved Urgent Care Centers. You should make sure that you are not walking into a facility that is called an Urgent Care but is only a regular medical practice marketing itself as an Urgent Care. Urgent care centers are primarily used to treat patients who have an injury or illness that requires immediate care but is not serious enough to warrant a visit to an emergency room. Often urgent care centers are not open 24 hours a day, unlike a hospital emergency room that would be open at all times. However, most real urgent care centers have extended hours in the evenings and are open on all weekends and holidays. Most true urgent
care centers will see children of all ages along with adults. Urgent Care centers are usually staffed by people with a background in either Emergency Medicine or Urgent Care Medicine and are able to treat a wide variety of conditions from suturing a laceration to treating a broken bone. The initial urgent care centers opened in the 1970s. Since then this sector of the health care industry has rapidly expanded to an approximately 10,000 centers until recently when a series of retail pharmacy based centers were closed. Most Urgent Care Centers were started by entrepreneurial ER physicians who have responded to the public need for convenient access to unscheduled medical care. Other centers have been opened by hospital systems, seeking to retain patient flow into their networks. Much of the growth of these centers has been fueled by the significant savings to the health insurance plan and the consumer that urgent care centers provide over the care in a hospital emergency department. Almost all managed care organizations now encourage their customers to utilize the urgent care option over an ER and will direct their members to an approved facility if the member was to call their membership hotline. Remember, many primary care offices are open for some hours in the evenings and weekends. However, unless these centers are open for walk-in patients of all age groups at all times when open for patients, offer on-site x-ray facilities, and care for most simple fractures and lacerations— these primary care physician offices are not considered true urgent care centers.
Become Your Own Health and Wellness Expert I want to express the importance of education yourself on even the basics of health care. This section gives you a start to some basic and detailed definitions, explanations and facts on who, what and where your health and wellness experiences may begin. However, even before that, educate yourself; know credentials to ask for and their meaning, research inspections, etc, these will enhance your “Return on Investment” for your own health. There are wonderful health & wellness providers and entities that should be given respect, but demand the same with your own health & wellness. Be the leader and take charge of your health and wellness.
16 RSVP Health | www.rsvphealth.com
When to go to an Urgent Care Center instead of the Emergency Room. Urgent care centers provide extended treatments for illnesses and injuries that you may not need an emergency room for, such as: • • • • • • • •
Sore throat or cold Bronchitis Nasal congestion or sinus problems Minor ear ache Minor stomach ache Continuing cough Urinary tract infection Other minor illnesses
Emergency rooms are for life threatening conditions that may quickly become life threatening, such as: • • • • • • • • • • • • • • •
Pain or pressure in chest Pain or pressure in upper stomach Trouble breathing or shortness of breath Loss of consciousness or fainting Sudden numbness or weakness Confusion, change in mental state Sudden change in vision Trouble speaking Sudden severe headache (with no history of migraines) Serious injury to the body Uncontrolled bleeding Major broken bones Seizures Severe reaction to an insect bite/sting, medication, or food Suicidal thoughts
Missouri Hospital Quick Stats In 2009, Missouri Hospitals added 1,100 jobs; while at the same time, 62,600 jobs were lost statewide. In 2008, Missouri Hospital payrolls and benefits totaled $7.1 Billion. In 2008, Missouri Hospitals provided $1.3 billion inpatient services for which they were not reimbursed. In 2008, Missouri Hospitals delivered 80,800 babies. In 2008, Missouri Hospitals had 2.6 million visits to their Emergency Rooms. In 2008, Missouri Hospitals performed 582,000 surgeries. In 2008, Missouri Hospitals performed 18 million outpatient procedures. In 2008, Missouri Hospitals invested $1.8 billion in buildings, land and equipment. Source: Missouri Hospital Association
Your Health Coverage Costs Do Not Stop By Dr. Rodney Gross, Ph.D. With Just Your Family. Benjamin A. Moss Since 2001, average premiums for family health insurance coverage have risen 78 percent and now stand at more than $12,000 annually, not including out-of-pocket costs, which average an additional $3,000, bringing the total to $15,000. However, hold on, you not only have to try to cover your family, you are responsible for a whole lot more. We all know about our tax dollars going towards the costs to provide health care for entities like Medicare, Medicaid, Veterans and even the U.S. Congress in which you pay 75 percent of their and their family’s coverage. Nevertheless, the U.S. Prison System produces staggering numbers that most of us are not aware and it is a subject that is left out by all political parties and news stations. My only intentions are awareness, statistics and empowerment for you.
U.S. Prison System $5 Billion in Health Care Costs 2.5 Million Prisoners.
On page 23 are “some” examples where your tax dollars are going towards the providing of health care to prisoners in the United States.
Again, this is not a political piece, but I believe that it is an important factor when talking about Health Care Reform, Health Care Crisis in America, Health Care Costs, etc. A couple of things to remember while you read this: There are 47 million uninsured in the United States. Almost 10 million are “children”, with the majority of these children living in two-parent families, and almost 90 percent have a working parent, but they still cannot afford to cover their children. Since 2000, the percentage of employers providing health coverage has dropped from 69 to 60 percent. As workers with private or employer-sponsored health coverage saw cost increases that far outpaced the rate of inflation and the growth in their wages, many also saw their benefits shrink. In most states, health insurers in the individual market can charge high premiums, exclude individuals with pre-existing conditions or deny coverage altogether to children likely to incur high health care costs. Through education and awareness, (It is ironic that the symbolism of justice is “the scales”) you have the power to balance the scales in your favor.
RSVP Health | www.rsvphealth.com 17
The spotlight continues to shine on Jefferson Regional Medical Center. ✚ The first medical center in the St. Louis region to earn Cycle III Chest Pain Center Accreditation from the Society of Chest Pain Centers. ✚ A 2009 HealthGrades Patient Safety Excellence Award winner for a patient safety record that ranks in the top 5 percent of hospitals nationally. ✚ Recognized nationally as a top hospitals for Overall Patient Safety and in Missouri for Surgical Patient Safety by CareChex, a quality rating service of the Delta Group. ✚ A 2009-2010 Best in Value Award winner from the Hospital Value Index, ranked as a Top 100 Hospital nationally and Best in Region for Quality, Affordability, Efficiency and Patient Satisfaction. ✚ One of five finalists for the St. Louis Business Journals’ annual “Best Places To Work” Contest for 2010.
Thank you to our physician partners, staff, volunteers and community. You make us shine. JEFFERSON REGIONAL MEDICAL CENTER Jefferson Health System
PO Box 350 | Crystal City, MO | 1.888.931.JRMC (5762) | www.jhsmo.com 18 RSVP Health | www.rsvphealth.com
We are your hospital.
RSVP Health | www.rsvphealth.com 19
20 RSVP Health | www.rsvphealth.com
RSVP Health | www.rsvphealth.com 21
22 RSVP Health | www.rsvphealth.com
Extended health care costs that affect your family.
U.S Prison System $5 Billion (2008) Since 1998 growth of 10% every year National prisoner rate of Hepatitis C is almost 50% $30,000 per year per prisoner for treatment of Hepatitis C $123 Million for health care for missouri prisoners (2008) All inclusive health care benefits at no costs, and no waiting period.
Medicare $599 Billion (2008)
Medicaid $204 Billion (2008) 40% of all childbirths in the U.S. 60% of all nursing home residents
U.S. Congress 2010 Base Salary is $174,000 Majority party leader is $193,400 Minority party leader is $193,400 Taxpayers pay 75% of their premiums RSVP Health | www.rsvphealth.com 23
Premier TIP Care
VNA TIP
HomeCare
TIPHospice
Senior Health Services | VNA TIP Home Care
With more than 90 years of trusted, experienced home health care provided by medical professionals giving top-quality care for patients and their families, VNA-TIP HealthCare knows a thing or two about in-home health care… What is Home Health Care? Home Health Care is often thought of as all of the health care services that can be provided in a patient’s home, nursing home or assisted living facility. While this term may be a “catch all”, Home Health Care is defined as health care or supportive care provided in a patient’s home by health care professionals (often referred to as formal care; in the United States, it is also known as skilled care). Skilled Care consists of services that must be performed by a licensed medical professional and overseen by a physician. Services may include a combination of professional health care; medical or psychological assessment, wound care, medication teaching, pain management, intravenous therapy, disease education and management, physical therapy, speech therapy, and occupational therapy. Medicare, Medicaid, and most other private insurance plans have a Home Health Care benefit, but require prior authorization and physician orders. The services requested must be reasonable and necessary for the treatment of the illness or injury. Home Health Care consists of intermittent visits to a patient’s home or independent living facility with a purpose of restoring and maintaining the patient’s level of function and health. Most insurance companies require the patient to be homebound, if leaving the home requires considerable and taxing effort. Home Health Care makes it possible for people to remain at home rather than use residential, longterm, or institutional-based nursing care. What is Hospice? Hospice is not a place but a concept of care, a philosophy of maintaining and managing a patient’s quality of life. If a person has a terminal illness or disease that is no longer responding to aggressive care, hospice may be prescribed by the primary physician. Hospice entails an integrated team of medical professionals that address all symptoms of a disease,
with a special emphasis on controlling a patient’s pain and discomfort, while educating and guiding the patient and family through the last phases of life. Hospice care consists of intermittent visits by skilled nurses, home health aides, medical social workers, chaplains and trained volunteers, while all care is overseen by one or more physicians. To qualify for hospice care, the patient must have a life threatening illness or injury and be deemed terminally ill by his or her physician (a life expectancy
Teamwork & Excellence of six months or less). Hospice care is covered by Medicare and Medicaid as well as most other private insurance plans. Other benefits of hospice include the coverage of medical equipment and medications pertaining to the primary diagnosis. Some hospice agencies offer a respite care option for caregivers who might need a temporary break. What is Private Duty? Private duty home care agencies are companies that provide home care aides, companion care, homemaker services, and even transportation. “Private duty” means private pay. The most common methods for covering the cost of private duty home care is through long term care insurance benefits, out of pocket, or other types of arrangements. Private Duty services respond to the individual needs of those who require assistance with activities of daily living. These services improve the quality of life by allowing the individual to live more independently, often bridging the gap between independent living and institutional care. Most agencies charge an hourly fee, and are available 24 hours a day, 7 days a week. The cost of these services is often less than the cost of a nursing home. RSVP Health | www.rsvphealth.com 25
Private Duty provides home care services that fall outside of the Medicare criteria of skilled, intermittent, short-term home health care.
Sleeping and Aging, Q&A
What if I need more than one service? Keep in mind that not all home health care providers are alike. At VNA-TIP HealthCare, we take pride in the quality, experienced and compassionate caregivers and medical professionals that make up our incredible team. Not only do we bring the latest in technology and proven methods of care and therapy to our patients, we work diligently to care for the patient and their best interests at all times. VNA-TIP HealthCare is able to provide our patients a continuum of services including Home Care, Hospice, Private Duty, Vaccinations, and Lifeline Services. What this means is a seamless integration of one or more categories of our services being provided to our patient, at the same time. For example, if we are caring for a patient receiving hospice care and find that the family needs help running household errands, caring for the home or cooking meals – we will work to fill in this gap by additionally providing private duty services in conjunction with their hospice care services.
Do older adults need as much sleep as younger people?
NA-TIP HealthCare takes pride in providing care in a V respectful, professional, and caring manner while meeting the highest possible expectations of each patient, family, and physician.
Sleep needs change over a person’s lifetime. Children and adolescents need more sleep than adults. Interestingly, older adults need about the same amount of sleep as younger adults -- seven to nine hours of sleep per night.
Ranked among the top 5% of agencies in the nation, VNATIP HomeCare is a dedicated team of skilled specialists who provide quality care services to the elderly, physically-handicapped, those recuperating from illness, injury or surgery. The VNA-TIP HomeCare caregivers commit to facilitating the patient’s recovery through teaching, quality care and support for the patient and family. When patients and families work with trained medical professionals guiding and caring for them, a speedier recovery and regained independence is the result.
What are the consequences of poor sleep for older adults?
TIP Hospice, a division of VNA-TIP HealthCare, is committed to serving the unique needs of patients with a terminal illness, and their family members. We are proud to offer the highest quality methods and technologies for pain and symptom management, as well as emotional and spiritual care of both patients and their families. TIP Hospice is devoted to nurturing hope and healing when lives are touched by the transitions that family illness, care giving and loss can bring. VNA-TIP HealthCare also offers private duty care, vaccinations and Lifeline services. With over 30 branches, VNA-TIP is the largest non-hospital affiliated home health care agency in the bi-state region, providing quality care through “Teamwork and Excellence” since 1917. For more information: 1.800.642.6099 or vnatip.com Available 24 hours a day, 7 days a week.
26 RSVP Health | www.rsvphealth.com
Older adults who have poor nighttime sleep are more likely to have attention and memory problems, a depressed mood, excessive daytime sleepiness, more nighttime falls, and use more over-the-counter or prescription sleep aids. Poor sleep is also associated with a poorer quality of life.
I have trouble falling asleep at night. Is that just a normal part of aging? Many people believe that poor sleep is a normal part of aging, but it is not. In fact, many healthy older adults report few or no sleep problems. Sleep patterns change as we age, but disturbed sleep and waking up tired every day are not part of normal aging.
As I get older, why do I tend to become tired earlier in the evening? The most common reason older adults wake up at night is to go to the bathroom. Prostate enlargement in men and continence problems in women are often the cause. Unfortunately, waking up to go to the bathroom at night also places older adults at greater risk for falling. Find more information visit http://nihseniorhealth.gov/sleepandaging/toc.html
RSVP Health | www.rsvphealth.com 27
Alzheimer’s Disease
Neuroimaging Initiative (ADNI) Generates Promising Early Findings By National Institute of Health
Scientists know that Alzheimer’s disease begins to take root decades before its initial symptoms appear. One of the great challenges for researchers is to pinpoint the earliest signs of Alzheimer’s before it can start to devastate a person’s brain structure, memories, and reasoning. After years of collecting data, the NIAsupported Alzheimer’s Disease Neuroimaging Initiative (ADNI) is yielding promising results about the structural and biochemical changes in the brain and the genetic variations that mark the onset and progression of Alzheimer’s disease.
associated with Alzheimer’s disease onset and progression. Another promising outcome is the development of a possible cerebrospinal fluid biomarker profile (pattern of biomarkers) for the onset of mild Alzheimer’s disease. ADNI researchers are also examining variations in genetic profiles that may be related to Alzheimer’s risk.
The original goal of ADNI was to define biomarkers for use in clinical trials, specifically to determine the best way to measure treatment effects in Alzheimer’s disease, says Principal Investigator Dr. Michael W. Weiner. “However, as the field has evolved, the goal has now extended to the use of biomarkers to detect Alzheimer’s at a pre-dementia stage.” Dr. Weiner directs the Center for Imaging of Neurodegenerative Diseases at the Veterans Affairs Medical Center in San Francisco and is a professor at the University of California, San Francisco.
Much recent work has focused on developing reliable ways to identify people with mild cognitive impairment (MCI) who will progress to Alzheimer’s disease, so that we can determine the kinds of disease changes that warrant further investigation. People with MCI often progress to Alzheimer’s—but they sometimes revert to normal cognition. An assessment of multiple measures helps to identify Alzheimer’s disease. These may include, for example: Volume of the hippocampus—a region of the brain involved in learning and memory Glucose metabolism in the brain Performance on tests of memory Identification of certain proteins in cerebrospinal fluid Plaques in the brain. The challenge for clinicians and researchers is to determine the specific combination of images and biomarkers that best predicts the development and progression of MCI and Alzheimer’s disease.
Preliminary data from ADNI are yielding some exciting results. For example, Weiner and colleagues found that structural magnetic resonance imaging (MRI), a technique that can determine, noninvasively, the detailed three-dimensional anatomy of the brain, has “huge potential” as a way to identify brain changes that are
The Search for Brain Changes and Biomarkers ADNI involves dozens of scientists at 59 study sites—54 in the United States and 5 in Canada—and is organized around eight
Launched in October 2004, this landmark study and public-private partnership has gathered and analyzed thousands of brain scans, genetic profiles, and biomarkers in blood and cerebrospinal fluid (CSF) in an ongoing effort to find more sensitive and accurate methods to detect Alzheimer’s disease at earlier stages and mark its progress. (Biomarkers are proteins and other substances in the body that can be used to measure the progress of disease or the effects of treatment.) “We’re trying to understand this disease at earlier and earlier stages so that we can provide patients with a therapy that will slow or halt the disease process,” says Dr. Neil Buckholtz, chief of the Dementias of Aging Branch in the NIA’s Division of Neuroscience. Although such a therapy may be years away, ADNI is working now to standardize the procedures and measures that scientists will use as they search for and test treatments that target the underlying disease.
28 RSVP Health | www.rsvphealth.com
75 year old Control
75 year old MCI
75 year old AD
MRI brain images showing shrinkage in the hippocampus (circled) and cerebral/entorhinal cortex (outer layer) in the brains of MCI and Alzheimer’s disease patients compared with the brain of a normal control. (Adapted from images provided by Dr. Michael Weiner, University of California, San Francisco.)
ADNI Study Cores and Substudies Cores: MRI FDG-PET Biomarker Biostatistics Clinical Informatics Genetics Neuropathology
Substudies: PIB-PET Biomarker qualification
core and two substudy areas (identified to the left). The 821 ADNI participants include about 200 older adults with Alzheimer’s, some 400 individuals with MCI, and about 200 cognitively normal people. Scientists have followed the participants with Alzheimer’s disease through visits every 6 months for 2 years and have followed the other participants for 3 years. Some of the leading-edge technologies under study are brainimaging techniques, such as positron emission tomography (PET), including FDG-PET (which measures glucose metabolism in the brain); PET using a radioactive compound (PiB) that measures brain beta-amyloid; and structural MRI. Brain scans are showing scientists how the brain’s structure and function change as Alzheimer’s disease starts and progresses. Biomarkers in cerebrospinal fluid are revealing other changes that could identify which patients with MCI will develop Alzheimer’s. Scientists are looking at levels of beta-amyloid and tau in cerebrospinal fluid. (Abnormal amounts of the amyloid and tau proteins in the brain are hallmarks of Alzheimer’s disease.) According to Dr. Buckholtz, the idea is to correlate the cognitive assessments and other methods currently used to diagnose and follow the disease with precise brain scan results, measurements of fluid biomarkers, and genetic analyses. This would relate the results of these tests to the symptoms a person may be having. Current evaluation methods alone cannot tell doctors and researchers whether a beneficial cognitive effect in an individual with Alzheimer’s or MCI results from the drug having a purely symptomatic benefit or whether it is actually slowing the progression of the disease, he says. It’s hard to say without additional data. ADNI is designed to help researchers overcome that limitation. “In medicine, there is almost never one best way,” Dr. Weiner says. “I think that as we learn more about Alzheimer’s disease biomarkers, different methods will be useful for different purposes.”
RSVP Health | www.rsvphealth.com 29
Early Results Starting To Roll In Dozens of early studies based on ADNI data have already been published, with many more to come as further data are collected and analyzed. These early findings have generated excitement among researchers. For example, a structural MRI study of 449 participants by Weiner and colleagues found that people with Alzheimer’s and MCI lost more volume in the hippocampus more quickly than did cognitively normal people, as shown by results of MRI scans at 6 and 12 months after obtaining baseline data. (The hippocampus, which plays a major role in learning and memory, is one of the first areas of the brain affected by Alzheimer’s. disease.) These losses were associated with deteriorating scores on cognitive assessments. In people with Alzheimer’s, higher rates of loss in hippocampal volume also correlated with the presence of the apolipoprotein E (ApoE) ε4 gene, a risk factor for Alzheimer’s. In people with MCI, higher rates of hippocampal loss were associated with lower levels of the peptide amyloid-beta 1-42 (Aβ1-42) in the cerebrospinal fluid.
pants with Alzheimer’s disease, while biomarkers for people who reverted to normal were similar to those of normal participants. “We’re very keen on the idea of testing the use of biomarkers for grouping study participants into those at highest risk of developing Alzheimer’s disease and those at least risk,” says Dr. Shaw. This stratification could help identify the best candidates for future clinical trials, he explains.
“The finding of accelerating hippocampal loss is important for understanding the natural history of the disease and emphasizes the need for early diagnosis and therapeutic intervention,” the researchers write.
Practical Benefits of ADNI Pharmaceutical companies also are starting to incorporate ADNI techniques into their trials, says Holly Soares, director of translational medicine at Pfizer Global Research and Development in Groton, CT, and chair of the ADNI industry scientific advisory board, which represents ADNI’s private partners. The value of the ADNI results lies in their utility for clinical trials of new drugs. Biomarker-based clinical trials will broaden the types of trials that drug makers conduct, Soares says. Some companies are beginning to plan for prevention studies, and having biomarkers that reliably predict who will progress to Alzheimer’s disease will help researchers identify ideal study participants. This ability to identify the best candidates for drug trials is perhaps ADNI’s greatest contribution to clinical-trial design, Soares adds. Biomarkers will help pinpoint people in the early stages of disease, define differences in the way the disease progresses, and reduce the number of participants needed to gain statistically powerful results. Smaller samples mean lower costs, too. A more targeted study population makes it easier to show whether new treatments work, says Dr. Russell Katz, director of the U.S. Food and Drug Administration’s Division of Neurology Products: “You can better focus your study on participants who are more likely to respond to your drug.” “Eventually,” Dr. Katz says, “we want to be able to say that when we fix the marker, we are likely to be helping the patient.” He adds, “The hope is that we’ll be able to treat people earlier
Other ADNI studies, including one published by Jack and colleagues, have shown that PET imaging holds potential for a different use: the identification of people with Alzheimer’s pathology who have not yet developed dementia. Weiner notes, “Detection of brain beta-amyloid can be used as a risk factor to predict future decline to Alzheimer’s disease.” In another recently published ADNI study by Dr. Leslie Shaw and colleagues at the University of Pennsylvania Medical School, cerebrospinal fluid samples from 410 volunteers showed lower levels of beta-amyloid, especially the insoluble type Aβ1-42, and higher levels of tau in people with the disease than in people with MCI. Likewise, people with MCI had lower Aβ1-42 and higher tau levels than did cognitively normal controls. These findings confirm the results of previous smaller studies. Of the 37 volunteers with MCI at the start of the study, 33 were diagnosed with probable Alzheimer’s a year later, while the other 4 were not. Regardless of outcome, cerebrospinal fluid biomarkers correlated well with those changes. Biomarkers in individuals who progressed from MCI to Alzheimer’s disease were similar to those of partici30 RSVP Health | www.rsvphealth.com
Another major ADNI contribution to the field has been the creation of a publicly accessible database. As it moves into the third year of data collection, the database contains more than 3,200 MRI scans, about 1,600 FDG-PET scans, about 960 cerebrospinal fluid measurements, genetic information, and other information, all maintained by the Laboratory of Neuro Imaging (LONI) at UCLA. “One of the successes of ADNI is that these data are freely available,” Buckholtz says. “The data are posted in real time. Any qualified researcher can request a password to access the data.” So far, thousands of researchers worldwide have accessed the data.
RSVP Health | www.rsvphealth.com 31
and earlier. ADNI is laying the groundwork to do that.” Future Directions As scientists collect and analyze more data, conferences are in the works to help reach a consensus on ways to standardize ADNI methods for clinical trials, according to Dr. Weiner.
As a major aspect of this study, the researchers will add people with earlystage MCI to the study population, says Dr. Buckholtz. Dr. Shaw adds that investigators would like to continue to analyze the There is help. Organizations like thousands of cerebrospinal the Alzheimer’s Association are fluid and plasma samples colthere to help. lected, testing the performance of amyloid and tau to predict conversion from MCI to Alzheimer’s, and looking to other biomarkers to refine the biomarker profile for Alzheimer’s.
Alzheimer’s Association www.alz.org
October 1, 2009, marks the start of the sixth and final year of ADNI under current funding. Investigators are hoping to obtain funding to continue the study for 5 more years. ADNI is currently supported by a $67 million public-private partnership. The Federal Government’s $40 million comes from the NIA primarily and the National Institute of Biomedical Imaging and Bioengineering, both parts of the National Institutes of Health. ADNI was recently awarded a Grand Opportunities grant from NIH as part of the American Recovery and Reinvestment Act.
Jack, C.R., et al. Serial PIB and MRI in normal, mild cognitive impairment and Alzheimer’s disease: implications for sequence of pathological events in Alzheimer’s disease. Brain. 2009. 132(5):1355-65. Schuff, N., et al. MRI of hippocampal volume loss in early Alzheimer’s disease in relation to ApoE genotype and biomarkers. Brain. 2009. 132(4):1067-77. Shaw, L.M., et al. Cerebrospinal fluid biomarker signature in Alzheimer’s disease neuroimaging initiative subjects. Ann Neurol. 2009. 65:403-13. Source: National Institute of Health, www.nih.gov
Know the 10 signs of Alzheimer’s Disease 1. Memory changes that disrupt daily life. 2. Challenges in planning or solving problems. 3. Difficulty completing familiar tasks at home, at work or at leisure. 4. Confusion with time or place. 5. Trouble understanding visual images and spatial relationships. 6. New problems with words in speaking or writing. 7. Misplacing things and losing the ability to retrace steps. 8. Decreased or poor judgment. 9. Withdrawal from work or social activities. 10. Changes in mood and personality.
32 RSVP Health | www.rsvphealth.com
RSVP Health | www.rsvphealth.com 33
Better Sleep. Better Life. More than 40 million Americans suffer from some sort of sleep disorder. Thirty million people—suffer from chronic insomnia, resulting in an estimated annual economic cost of $30 billion in lost productivity, as well as profound loss of quality of life. Insomnia can create extreme stress at home and at work, as well as impaired mood and physical problems.
34 RSVP Health | www.rsvphealth.com
So What Is Insomnia? Insomnia is, simply, persistent problems in falling or staying asleep. People with insomnia typically complain about poor or unrefreshing sleep and often suffer from consequences such as drowsiness and lack of focus during waking hours.
It’s what kind of insomnia? In general, there are three main types of insomnia, and properly identifying the type is a critical element in creating the right individual treatment plan. Acute Insomnia Acute insomnia is relatively short term, usually lasting up to one month—which may feel like an eternity! Life changes, persistent stress, physical illness or emotional strain are often the sources of acute insomnia. When the cause is eliminated or resolved, good sleep will likely return, so addressing the source is key. Co-Related or Co-Morbid Insomnia This insomnia occurs at the same time as another health issue—it is associated with that health issue and is often marked by impairment during waking hours. Common health risks and disease states associated with co-morbid insomnia include: • Sleep apnea • Restless leg syndrome • Chronic pain • Heart disease • Heartburn (“GERD”—gastroesophogeal reflux disease) • Depression and anxiety • Dementia • Multiple sclerosis For successful diagnosis and treatment, these compound physical and mental conditions require complete, careful compilation of data about, and thorough evaluation of, each individual patient’s health and disease states.
Do You... • Have difficulty falling asleep? • Have difficulty staying asleep? • Awake many times during the night? • Wake up too soon? • Wake up feeling unrefreshed? • Notice unexplained increases in your wieght?
Primary or Chronic Insomnia Primary insomnia lasts longer than one month and has no connection to another issue or condition. Causes of primary insomnia are specific to the individual and often a composite of biological, behavioral and congnitive factors. Symptoms form primary insomnia frequently become most apparent in the middle adulthood , when an individual’s traits, behaiors and mental patterns have been established for some time. Particularly with primary insomnia the key to successful treatment is accurate diagnosis. Take Your Insomnia Seriously. We Do! If you have insomnia, or even think you have insomnia, do not ignore it. Talk to your doctor. Ask about The Insomnia Center at Clayton Sleep Institute or call (314) 645-5585 to speak with one of our insomnia patient specialists. We are dedicated to unraveling the mystery and the frustration of insomnia for you! What is the Clayton Sleep Institute? Sleep affects every aspect of health; it is vital to our sense of wellbeing. With more than 40 million Americans suffering from some sort of sleep disorder, you can’t afford another bad night’s sleep. Clayton Sleep Institute (CSI) is a leading independent organization founded, directed and managed by expert medical, research and technology professionals dedicated to all aspects of sleep medicine and healthy sleep.
If you have one or more of these symptoms, talk to your physician about The Ensomnia Cneter at Clayton Sleep Institute, or call us directly for more information. Respecting what your mind and body are telling you, acknoledging the serious nature of insomnia and asking for help are the first steps toward better sleep and better health!
Are you feeling... • Fatigue? • Decreased concentration? • Impaired memory and mood? • Poor judgment and physical coordination? • Irritability? • Noticeable anxiety?
RSVP Health | www.rsvphealth.com 35
Help Your Insurance Company Help You! | By Rodney D. Gross, Ph.D.
If you have insurance, you need to educate and enhance your return on investment by knowing your policy. We all have faced at some point in the decision to take ourselves, family members and or friends to the Emergency Room or not. It normally happens at the most inconvenient times to include outside the normal hours of your regular primary care physician. There are universal agreements in the medical community in what symptoms you should seek immediate medical attention at the nearest Emergency Room and or dialing 911. Some of the obvious ones are chest pains, shortness of breath, uncontrolled bleeding, loss of
Help Your Insurance Company Help You!
“In 2007, close to 20 million Emergency Room Visits were considered non-urgent.”
consciousness, sudden changes in vision, broken limbs, etc. We all know about the rising costs of health care and one of the reasons is the overuse and misuse of Emergency Rooms for non-related emergencies. It is more expensive for Hospitals, Insurance Companies and most importantly “you”. You will pay more than at least four times the amount and higher depending on the non-emergency related illness, for treatment in an Emergency Room versus your regular Primary Care Provider and or an Urgent Care Clinic. Hospitals, Private Doctors and Drug Stores have opened Urgent Care, Convenient Care, Extended Hour and Walk-In Clinics to enhance access for their patients and the public. As I mentioned, Hospitals, yes-even Hospitals are now investing money and resources in building these types of clinics either within the hospital and or in the communities they serve, to offset their costs from their own Emergency Rooms. You may even see one of these located next to an Emergency Room. Your Insurance Carrier is listing the new clinics you see popping up everywhere in their Provider
36 RSVP Health | www.rsvphealth.com
Directories so you are able to locate them within and around your area and areas that you may be traveling. They also include toll free numbers for you to call to locate the nearest one to you and to help you if you need guidance in deciding whether to go to the Emergency Room or one of these centers. Some carriers are on the forefront of education and empowering their customers and the public. They are educating their customers to help both sides in optimizing the health care experience while ensuring both yours and their Return on Investment. Some truly believe that education and awareness will lower the cost to provide their products so that their existing customers and consumers will have less financial strains related to Health Care and Health Insurance. Building this type of relationship builds trust and they know if they can be on the forefront of health care education and awareness, then the consumer will look towards them when making a choice about Insurance Coverage. The following is an example of one Insurance Carriers’ Comparisons of Emergency Room Costs versus Urgent Care Costs for some of the most common occurrences. The numbers are “averages” based on what the Hospitals Billed versus what the Urgent Cares Billed and what the member paid in both categories for their members in several different states. Depending on the specific coverage and further ancillary testing (Labs, X-Rays, etc.), the member costs for Emergency Room Visits and Urgent Care Visits could be higher. “In 2007, close to 20 million Emergency Room Visits were considered non-urgent.”(CDC’s National Center for Health Statistics) You are being given choices that “you” ultimately have the decision. Know the costs, know the hospitals, know the doctors, know the symptoms and know your policy. You have the power to control your health care costs and just might be able to help slow the cost to provide Health Care and Health Care Insurance. It is your Return on Investment.
(Common Cold) Urinary Tract Infection (UTI)
$25.00
$90.00
$210.00
$465.00
Costs for medical visits
(Varies by provider and insurer, check with your entities for exact information)
Abdominal Pain Acid Reflux Back Pain Ear Ache Flue Symptoms (Viral) Gastritis Headache Pink Eye (Conjunctivitis) Rash (Cellulitis) Sore Throat (Strep Throat) Strains/Sprains Upper Respiratory Infection (Common Cold) Urinary Tract Infection (UTI) $0
Average Costs
$375.00
$750.00
$1,125.00
Member Costs (Urgent Care)
Urgent Care Costs
Member Costs (ER Visit)
ER Visit Costs
$25.00
$58.46
$166.54
$593.08
$1,500.00
Anthem Blue Cross and Blue Shield health coverage for you and your family. Strong protection. Strong network. Life is full of risks. And the time to think about a health plan is before you need it. When your child is no longer eligible for coverage under your plan, individual health coverage can be a bargain. So, don't wait! Call Anthem Blue Cross and Blue Shield today!
ROBERT BLANKENSHIP
Authorized Independent Agent
(573) 431-2222
Solutions with choices are easy. Call today for a free personalized quote.
509 East Main Ste D Park Hills, MO 63601 (573) 431-6272 bblankenshipinsuranace@yahoo.com www.bobblankenshipinsurance.com
Robert Blankenship is an independent authorized agent in Missouri for Anthem Blue Cross and Blue Shield. In Missouri, (excluding 30 counties in the Kansas City area) Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees Health www.rsvphealth.com 37 of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names andRSVP symbols are registered |marks of the Blue Cross and Blue Shield Association.
Obesity in children in 2008.
Obesity in children in 2010.
Take charge of your weight. By Benjamin A. Moss Dr. Rodney Gross, Ph.D.
Weight loss commercials abound like Starbucks in New York City. Obesity rates are at an all time high in the U.S. According to the CDC, 60 million adults or 30% of the adult population are now considered obese. Since 1980, the rate of overweight children has doubled, it has tripled in adolescents. Type 2 diabetes is now being diagnosed in young people, where in the past is was considered to only affect adults. Overweight children with type 2 diabetes are at risk of suffering severe complications such as kidney disease, blindness, and amputations. Sixty-one percent of overweight children between five and ten years of age already have one risk factor for hear disease (CDC, Facts About Obesity in the United States). It has been identified that most Americans do not practice good health behaviors that can prevent obesity. Simple behaviors like eating five or more servings
38 RSVP Health | www.rsvphealth.com
of fruits and vegetables per day will have a positive impact on your health. Be active on a daily basis in some form is vitally important, the recommendations are different for each age group and vary by the type of activity. For instance, a little over 20 minutes of brisk walking each day for adults 18 to 64 can reduce the risk of developing or dying from leading causes of illness and death in the U.S. Everyone wants to change, but how and what do you need to do? It is now time to act. Today! Let’s take a look at some barriers as identified by the National Institute of Health and the solutions to taking the first step, getting active. Be informed and in charge of your weight, stand up and take the first step to good health, get active.
Ob ad in 2
besity in dolescents 2010.
The key is going beyond talk and start doing. Any great conqueror knows you don’t take the city in a day. You can conquer your obesity by taking one more step everyday then you did the day before. Be encouraged, be proud of what you are doing! When you get down on yourself, get back up and keep going. Maintain your new active lifestyle by setting goals and find friends to take the journey with you. Find rewards and track the progress you make, it will be somewhat rewarding in itself to see all that you are doing. In no time, you will be on track to an active lifestyle!
Don’t let these or any other barriers stop you from being active. Barrier: I don’t have enough time! Solution: Be active for a few minutes at a time throughout the day. Sit Less. Try to walk more while doing your errands, or schedule lunchtime workouts to boost your overall activity. Plan ahead and be creative!
Barrier: I just don’t like exercise. Solution: Good news—you do not have to run or do push-ups to get the benefits of being physically active. Try dancing to the radio, walking outdoors, or being active with friends to spice things up.
Barrier: I feel self-conscious when I’m active. Solution: Be active at home while doing household chores, and find ways to move more during your day-to-day activities. Try walking with a group of friends with whom you feel comfortable.
Barrier: I can’t stay motivated! Solution: Try to add variety to your activities and ask your friends to help you stay focused on being active. Consider an activity video for extra encouragement. Also, set realistic goals, track your progress, and be sure to celebrate your achievements!
Barrier: I’m worried about my health or injury. Solution: You might feel better if you talk to a health care professional first. Find a fitness provider to guide you, or sign up for a class so you feel safe. Remember that activity does not have to be difficult! Gentle activity is good too.
Source: National Institute of Health
RSVP Health | www.rsvphealth.com 39
“Don’t wait. The time will never be just right.”
-Napoleon Hill
Some tools to help along the way.
Nike + iPod Nike + iPod
Lose it
Weight Watchers
Wii Fit
It is always easier to win with a team, take a look at their programs, become involved to be and get support from others. ww.weightwatchers.com
A great way to get started in the comforts of your living room. Anything that helps your fitness levels while having fun is always a plus. www.wiifit.com
New toys are great, get you a new pair of shoes and connect them to you ipod or iphone to keep track of your expeditions on or off the beaten path. www.apple.com/ipodtouch/features/nike.html
40 RSVP Health | www.rsvphealth.com
Great application for iphone and online that allows you to keep track of your food intake and helps set goals to get to an ideal weight. www.loseit.com
What is Chiropractic and its History | By Lisa R. Long, D.C.
Chiropractic is a branch of the healing arts which is concerned with human health and disease processes. Doctors of Chiropractic are physicians who consider man as an integrated being and give special attention to the physiological and biochemical aspects including structural, spinal, musculoskeletal, neurological, vascular, nutritional, emotional and environmental relationships. The practice and procedures which may be employed by Doctors of Chiropractic are based on the academic and clinical training received in and through accredited chiropractic colleges and include, but are not limited to, the use of current diagnostic and therapeutic procedures. Such procedures specifically include the adjustment and manipulation of the articulations and adjacent tissues of the human body, particularly of the spinal column. Included is the treatment of intersegmental aberrations for alleviation of related functional disorders. Chiropractic is a drug-free, non-surgical science and, as such, does not include pharmaceuticals or incisive surgery. Due regard shall be given to the fact that state laws, as well as the nation’s antitrust laws, may allow Doctors of Chiropractic to utilize ancillary health care procedures commonly referred to as being in the common domain. The roots of chiropractic care can be traced all the way back to the beginning of recorded time. Writings from China and Greece written in 2700 B.C. and 1500 B.C. mention spinal manipulation and the maneuvering of the lower extremities to ease low back pain. Hippocrates, the Greek physician, who lived from 460 to 357 B.C., also published texts detailing the importance of chiropractic care. In one of his writings he declares, “Get knowledge of the spine, for this is the requisite for many diseases”.
Daniel David Palmer went on to begin the Palmer School of Chiropractic, which has continued to be one of the most prominent chiropractic colleges in the nation. Throughout the twentieth century, doctors of chiropractic gained legal recognition in all fifty states. A continuing recognition and respect for the chiropractic profession in the United States has led to growing support for chiropractic care all over the world. The research that has emerged from “ around the world” has yielded incredibly influential results, which have changed, shaped and molded perceptions of chiropractic care. The
What is Chiropractic and its History report, Chiropractic in New Zealand published in 1979 strongly supported the efficacy of chiropractic care and elicited medical cooperation in conjunction with chiropractic care. The 1993 Manga study published in Canada investigated the cost effectiveness of chiropractic care. The results of this study concluded that chiropractic care would save hundreds of millions of dollars annually with regard to work disability payments and direct health care costs. Doctors of chiropractic have become pioneers in the field of non-invasive care promoting sciencebased approaches to a variety of ailments. A continuing dedication to chiropractic research could lead to even more discoveries in preventing and combating maladies in future years. Works Cited
In the United States , the practice of spinal manipulation began gaining momentum in the late nineteenth century. In 1895, Daniel David Palmer founded the Chiropractic profession in Davenport , Iowa . Palmer was well read in medical journals of his time and had great knowledge of the developments that were occurring throughout the world regarding anatomy and physiology. In 1897,
Chapman-Smith, David: The Chiropractic Profession. West Des Moines, Iowa, NCMIC Group Inc., 2000: 11-17, 70-71. Chiropractic: State of Art. Arlington, Virginia, American Chiropractic Association, 1998: 2-3, 12-14. Spinal Manipulation Policy Statement. Arlington, Virginia: American Chiropractic Association, 1999: 6.
RSVP Health | www.rsvphealth.com 41
Are we thankful to those who protect
our country,
our freedoms and us? By Dr. Rodney Gross, Ph.D. (USAF Disabled Veteran)
It is ironic that I am writing this over the Fourth of July weekend with the subject matter being something very personal to me, American Veterans. I watch program after program and major news stations reporting on the patriotic symbolism of this holiday. Leaders from the very top of our government from all political parties to the talk show hosts blabbering on and on, about how one should be proud of this country. Surprising to some as it may be, the majority of these do not have any clue on the meaning of patriotism, devotion, sacrificing, etc, for this country. Look at all political leaders no matter what party and see how many ever served in the Armed Forces or even had a relative serve and do the same for the other so-called experts and movement groups. There is one group who can tell you the meaning of unselfishness, devotion, allegiance, and patriotism, those who actually served in the Armed Forces, Veterans. They “volunteered” to serve their country and so many made the ultimate sacrifice for protecting this country, your freedoms and you. They do this service for the country because the majority of the individuals listed above would not, but the individuals sure talk a good service. Maybe that “good talk” is why some of the alarming statistics that I have found is happening and so heart wrenching. In a quarterly report from Congress in Nov 2009, at that time 334 members of the military services had committed suicide. That is more than had been killed in either the Afghanistan (297) or Iraq (144) wars. Another unbelievable statistic I found was that at Fort Campbell in Kentucky (home of the 101st Airborne) alone, the number of patients treated at the behavioral
42 RSVP Health | www.rsvphealth.com
health clinic increased by 60% from 25,400 in 2008 to almost 40,000 in 2009. In the US Army, there were 197 suicides in 2008, 245 in 2009 and 163 through May 2010. The Department of Veterans Affairs said, “An average of 53 Iraq and Afghanistan veterans committed suicide each year between 2002 and 2006”. Veteran Affairs Secretary Eric Shinseki said at a VA-sponsored suicide prevention conference, “Of the more than 30,000 suicides in this country each year, fully 20 percent of them are acts by veterans. That means on average 18 veterans commit suicide each day. Five of those veterans are under our care at VA.” A study by the Harvard Medical School stated in its’ findings the following: One in every eight of uninsured Americans is a veteran or member of a veteran’s household; Two million veterans were uninsured in 2004, up almost 300,000 since 2000, with an additional four million members of their households were also uninsured and ineligible for VA care; Of the two million veterans uninsured, 645,628 were VietnamEra veterans while 1,105,891 were veterans who served during other eras (including the Iraq and Gulf Wars); Of the uninsured veterans, 57% were older than 44 Note: Remember that this study was in 2004 and released in 2007. Do you think the numbers decreased, stayed the same or increased?
Other Veteran Facts & Figures An estimated one-third of the adult homeless population served this country in a branch of the Armed Forces. That is estimated around one million. Veterans of just the Iraq and Afghanistan wars are at a 12% unemployment rate. That equals over 160,000 and that is about the same as the number of U.S. troops deployed to those two wars. February 2009 saw the rise of veteran unemployment to one million. That more than doubled from 2008.
me sir. He thanks me for coming to visit him and that it was an honor to serve under me. This particular man had not fed himself for some time nor did he move on his own. The second man always gazed somewhere past who was ever in the room, but again when I walked in and started to thank him, I noticed his eyes shift to the flag I was carrying, then his eyes shifted to my rank on my jacket. I realized I needed to salute him because he out ranked me and when I did, he saluted “me� back, thanked me and asked me if we were done. The catalyst for this interaction was the patriotic symbolism that they stood for, our American Flag. To their last breath and beyond, I know in my heart that they forever will serve this country. Please remember what these veterans do for you and our country. They do and did what the majority of the country does not; they take an oath to die for you and this country to ensure our freedom. The ironic thing (if you do not believe me, go to a VA Hospital for a day and ask veterans if they had to do it again or go right now for this country, would you), they are ready no matter what their situation, to always serve our country.
February 2009 saw the rise of veteran unemployment to one million. That more than doubled from 2008.
As a Health Care Professional, you are exposed to so many experiences that help shape you as a person. One memory that I will never forget is one where I was a CEO of a Medical Center with a Nursing Home and each year I would walk around with the local VFW Chapter, handed out flags, letters of appreciation and thank veterans for their service to their country who were patients and or residents. There were two males around the same time and in their eighties or later, both on different wings of the Nursing Home, not knowing one another. What they had in common was that they were veterans. Both were not very aware of their surroundings nor did they recognize their loved ones, but when I walked in the first man’s room with my military jacket and flags, he rose up from bed enough to salute me and call
RSVP Health | www.rsvphealth.com 43
What is Service? It seems our definition is continually diminishing with what we actually experience, but our hearts remember the “good ole days”, when you were greeted by name, with a smile and businesses would come to your home to make it easier and convenient for you, the consumer. USA Drug works hard to provide you the service of past generations!
Services Provided Free of Charge: • • • •
Delivery for medications and equipment. Medicare part D and Spend Down Experts to assist you. Twice weekly grief and loss suppor group. Patient advocate that assists customers with obtaining medications free of charge through various programs. • USA Ddrug fills it’s own oxygen to be able to serve the community in times of great need. • Six nurses that are cmployed to offer community screenings. • Three retail locations have robotic technology to assist in faset and accurate prescription filling that allows wait times to be less than 20 minutes. 44 RSVP Health | www.rsvphealth.com
Check our out new website at USADrugMissouri.com USA Drug has chosen this philosophy of business in order to differentiate ourselves from other providers. We choose to provide these services because we truly Care about our customers and our communities. We are happy to provide these services at a cost of over $1 Million dollars a year! So what is the bottom line? WE WANT YOU AS OUR CUSTOMER! This will allow us to continue to serve our communities with additional services and make healthcare as easy as possible!
8 RETAIL PHARMACIES— FARMINGTON, DESLOGE, BONNE TERRE, IRONTON, SULLIVAN, LINN 1 LONG TERM CARE PHARMACYFARMINGTON 6 NURSES ON STAFF PROVIDING FREE HEALTH SCREENINGS 2 RESPIRATORY THERAPISTS ON STAFF PROVIDING HOME ASSESSMENTS OXYGEN, CPAP, BIPAP SERVICES POWER AND MANUAL MOBILITYWHEELCHAIRS FREE PRESCRIPTION AND EQUIPMENT DELIVERY TO 17 COUNTIES SPEND DOWN ASSISTANCE PATIENT ADVOCATE ASSISTANCE GRIEF AND LOSS SUPPORT GROUP HUGE COMMUNITY INVOLVEMENT AND SPONSORSHIP
ASK THE EXPERT Danielle Redecker, Pharm.D. | USA Drug
Would I be a candidate for the shingles shot? Shingles is a painful skin rash. If you have ever had chicken pox or the chicken pox vaccine, you could get shingles. However, unlike the chicken pox, shingles can come back many times. The main symptom of shingles is severe pain, but it can also cause a fever, headache, or even pneumonia. In fact, about one in five people can have pain that lasts for weeks after the rash is gone. The shingles vaccine is called Zostavax®. If you are 60 years old or older, you may be a candidate for getting this vaccine. The vaccine will help reduce the risk of an initial shingles outbreak, as well as help reduce the pain associated with the infection. Your USA Drug pharmacist may be able to administer this vaccine without having to make a trip to your doctor’s office, so just ask your USA Drug pharmacist to see if you would benefit from getting this vaccine! I take my vitamins in the morning with my other medications. Can I take them together? Almost everyone should take a daily vitamin to ensure that you are getting all of the vitamins and minerals your body needs. However, vitamins can interact with several medications. If taken at the same time, these medications might not work as well. Some examples include: certain antibiotics (Cipro®, Levaquin®), thyroid medications (Levoxyl®, Synthroid®, levothyroxine), and osteoporosis medications (Fosamax®, Boniva®, Actonel®). Try to take your medications one hour before or at least two hours after taking any vitamins. Always ask your USA Drug pharmacist about your specific medications. My doctor wants me to take my cholesterol medicine, Zocor®, in the evening, but I have a difficult time remembering to take it at that time. Can I take it in the morning? Taking a “statin” cholesterol medicine like Zocor® (simvastatin) in the evening is a wonderful idea. This is because the liver makes cholesterol while you sleep. If you take your medicine in the evening before going to bed, it will probably lower your cholesterol better than if you take it in the morning. However, if you cannot remember your medication at night, taking it in the morning is better than not taking it at all! Many medications work better if taken at certain times of the day. Please ask your doctor or USA Drug pharmacist about a medication regimen that would work best for you! Danielle Redecker is a pharmacist for USA Drug who grew up locally and earned her doctorate at the St. Louis College of Pharmacy. Danielle is happy to fulfill her lifelong dream of being your hometown pharmacist, and can be found at the USA Clinic at Mineral Area Hospital. Feel free to stop by and ask her your pharmaceutical RSVP Health | www.rsvphealth.com 45 questions.
Is Your Drug Cabinet Creating Addiction? One of the growing problems in the United States is prescription drug abuse. When you use prescription drugs for something other than their prescribed use, that is abuse - whether you do it one time or one hundred times. Merriam-Webster Dictionary defines addict as: to devote or surrender (oneself) to something habitually or excessively”. Prescription drugs are easy to abuse because they are so easy to find and it is not just getting them from the doctor. The National Institute on Drug Abuse reports that most people who abuse prescription drugs get them from relatives or friends as people share their prescriptions with others - or even as abusers steal them from their medicine cabinets or purses. Another factor that contributes to prescription drug abuse in America is the fact that so many people think that because medications are legal, they are safe. Unfortunately, this is not true, despite the perception. Prescription drugs are only safely used by those to whom they have been prescribed, and only when following directions. In fact, these so-called “legal” drugs are not actually legal when they are not taken according to physician instructions. This makes it easier for abusers to “pharm” prescriptions drugs. This practice of taking handfuls of drugs from wherever possible is especially growing among the youth. According to the Centers for Disease Control (CDC), more than six million people over the age of 12 will begin abusing prescription drugs. While the abuse of illicit drugs goes down, more and more people begin to abuse “legal” prescription drugs. This is a 46 RSVP Health | www.rsvphealth.com
By Dr. Rodney Gross, Ph.D., Benjamin A. Moss
fast-growing trend in the United States. Even more alarming is the fact that young people aged 15 to 24 is the fastest growing demographic of prescription drug abuse. The U.S. Department of Health and Human Services (HHS) reports that nearly 3 million teenagers and young adults (those aged 12 to 25) become new abusers of prescription drugs. 56 percent of the 6 million new prescription drug abusers were over the age of 18. Prescription drug abuse is rising among the elderly as well. Even though only 13 percent of the population, the elderly account for about 1/3 of the prescriptions. The National Institutes of Health (NIH) estimates that close to 20 percent of people (48 million) over the age of 12 in the U.S. have used prescription drugs for non-medical purposes. According to U.S. Substance Abuse and Mental Health Services Administration’s (SAMHSA) Drug Abuse Warning Network (DAWN) emergency department system, which examines emergency department visits for non-medical use of prescription drugs, a steep rise in U.S. emergency departments visits by people abusing prescriptions pain drugs such as OxyContin, Vicodin and Dilaudid. In fact, between 2004 and 2008 the abuse of “opioid” medications like these increased more than 111 percent overall and 29 percent during 2007-2008 alone. Misuse of oxycodone (brand name OxyContin) rose 152 percent between 2004 and 2008 alone that produced over 105,000 emergency room visits. For products containing hydrocodone (Vicodin, for example), emergency department visits rose 123 percent, the heroin substitute methadone, emergency room visits rose 73 percent and the drug hydromor-
phone (Dilaudid), emergency room visits soared 259 percent. One of the contributing factors of this rise is attributed to “socalled” role models. We all have witnessed numerous movie stars dying from overdoses, checking into rehabilitation centers, etc, almost on a daily routine. We even see radio personalities, politicians and their spouses, do the same. The sad fact is that in August 2009, the (CDC) reported that the leading cause of accidental poisonings among American children can be found in the family medicine cabinet and each year, more than 71,000 aged 18 and younger are seen in emergency rooms for overdoses of prescription and over-the-counter drugs. In 2006, approximately 7 million people in the U.S. were current users of psychotherapeutic drugs taken non-medically (2.8 percent of the U.S. population). This class of drugs is broadly described as those targeting the central nervous system, including drugs used to treat psychiatric disorders. Here is a list of some of the most recognizable abused prescription drugs: Opioids, such as OxyContin and Vicodin, which are most often prescribed to treat pain. Note: Since 1994, use of these drugs for non-medical purposes has grown 450 percent. Central Nervous System (CNS) Depressants, such as Valium and Xanax, which are used to treat anxiety and sleep disorders. Note: Since 1994, use of these drugs increased 170 percent. Stimulants, which are prescribed to treat certain sleep disorders and attention deficit hyperactivity disorder (ADHD) and includes drugs such as Ritalin and Adderall. Note: Almost 1 million of first time abusers of this drug surface each year. The following is a breakdown of the risks associated with prescription drug abuse: Opioids High risk for addiction and overdose is a major concern, particularly for recently synthesized slow release formulations, which abuser override by crushing the pills and injecting or snorting the contents, increasing their risk for respiratory depression and death. Dangerous combination effects with other drugs, including alcohol, can intensify respiratory distress. Injecting these drugs increase the risk of HIV and other infectious diseases through use of unsterile or shared equipment, such as needles. CNS Depressants These drugs can be highly addictive and, in chronic users, discontinuing them absent a physician’s guidance can bring about severe withdrawal symptoms that must be properly managed by a medical professional. Overdose can cause severe breathing problems and lead to death, especially when these drugs are combined with other medications or alcohol. Stimulants Incorrectly perceived as safe for enhancing academic achievement and weight loss, these drugs are highly addictive and potentially harmful. Risk of dangerously high body temperature, seizures and cardiovascular complications.
The following is “some” of the signs one can look for that “may,” indicate an addiction to prescription drugs: Behavior Prescription drug abuse can cause withdrawal from one’s social life. Addicts withdraw from activities they used to enjoy while becoming reclusive. Dramatic drops in grades at school or in one’s performance at work. Increased frequency in moodiness and increase in violence and or violent behavior. Increased secrecy and paranoia can also be signs. Continued Use Long-timed use with no visible improvement in the said condition that was prescribed. Fake symptoms for continual prescriptions. Routine switching of Doctors. Taking more than the prescribed amount. Appearance Sudden weight loss and loss of appetite. Noticeable change in hygiene and grooming. The key to remember is that not one sign indicates anything, but a combination of some of these signs “may”. Prescription drug abuse can be very devastating. It can destroy relationships, cause serious health problems and even be a cause of death. If you are concerned about a loved one or a friend, do not accuse and make it clear that you are worried and want to help. The most common way is to start out saying something like “I noticed something out of the ordinary and I want to make sure everything is all right”. Most people will get defensive and angry, but even if they do not admit anything right then, they may wake up to the fact that help is needed. Many people make the mistake of thinking that just because prescription drugs are “legal” they are also safe. It is important to know that the abuse of prescription drugs is actually illegal. They want to experiment and have a good time, but worry about the dangers of illicit drugs. Unfortunately, they do not realize that prescription drugs can be just as dangerous as illegal drugs. Educating yourself is the first step of awareness to prescription drug related problems. Inventory your medicine cabinets and encourage your other family members to do the same especially if you find things missing. Do not share any prescribed medications with anyone nor take any from other than whom it was prescribed. If you or your family has an ailment that is not getting better but the doctor just keeps giving refills, you may want to get a second opinion. Learn about the medications being prescribed. You can ask the local pharmacists; go on the web or to a bookstore to get free information on any medication. You can also contact your local pharmacy to see about disposing of prescription drugs, many are now offering “take-back” programs for unused and or expired prescription drugs. Do not flush the prescription drugs down the toilet (this is becoming an environmental hazard, especially in our waterways). You are in control of your households medicine cabinet and its’ supply, do not let it become a source of addiction. RSVP Health | www.rsvphealth.com 47
Taking Care of What Matters Most, even when it’s inconvenient.
48 RSVP Health | www.rsvphealth.com
Midwest Health Group Convenient Care
Midwest Health Group’s Convenient Care realizes that our communities we serve are busier than ever. As individuals and families worry about work, kids, schools, shopping and a whole lot more, we further realize that there are times when you or a family member becomes ill. We know how difficult it is sometimes to stop, make a call and try to get into your Primary Care Provider and in addition, we understand the struggles to walk into an Emergency Room for non-life threatening illnesses. Even if you have family or friends visiting the area, we are here for them. Maybe you are just traveling through or visiting the area, we are here for you. By understanding you, your schedules and your budget, we enhance unexpected and inconvenient health issues when they may arise through total convenience for you. We offer you access with expanded hours, no phone calls or appointments necessary, minimal to no wait times and comprehensive services that include onsite lab & x-ray services, just to name a few, at a much reduced rate than a Emergency Room Visit for non-life threatening illnesses. In addition, our staff of Physicians and Nurse Practitioners is readily available to see you for Minor Injuries, Flu Symptoms, Rashes, Colds, Sore Throats, Insect bites, Urinary Tract Infections, Minor Lacerations and Stomach related problems, etc. It is not our intention to replace your regular Primary Care Provider, but to offer you options when they may not be available. We will make every effort to ensure that your visit and services performed be shared with your regular Primary Care Provider with your consent no matter where they may be located. If you are a new patient, we offer you the same services with additional medical management and comprehensive care (Diabetes, High Blood Pressure, Arthritis, Acid Reflux, etc) of a Primary Care Provider with specialties
within our group such as Cardiology, ENT and Gastrointestinal to name a few. By incorporating our network into your health, we ensure continuity of care and always maintaining medical management of our patients. Striving to enhance your health care experience, we are always trying not to add to your busy schedule of having to drive in all directions to see Specialists or have Ancillary Test done, therefore, we always have your “convenience” in mind by incorporating other specialties and testing equipment. If you are a business, we offer you and your employee’s comprehensive services as mentioned above for Workman’s Compensation Benefits when they may arise. In addition, we offer Drug Screenings for Pre-Employment & Post-Accidents and Work Physicals to include Department of Transportation (D.O.T) Physicals. We accept most Insurance, Medicare, Medicaid and Workman’s Compensation. We realize that not everyone has insurance and having that in mind, we proudly offer our fees and tests at a very reasonable rate compared to what you may pay at an Emergency Room. Our services are always available to you at those inconvenient times and if you were looking for a Primary Care Provider, it would be our pleasure. We invite you to stop in, visit our facility, and please feel free to contact us by phone, email and or visit our website. Midwest Health Group Convenient Care 507 W. Pine St., Farmington, MO 63640 Phone: 573-454-2466 www.midwestconvenientcare.com
RSVP Health | www.rsvphealth.com 49
50 RSVP Health | www.rsvphealth.com
RSVP Health | www.rsvphealth.com 51
Joachim-Plattin Ambulance District (JPAD)
24 full-time paramedics 30 part-time on duty 4 fully equipped life support vehicles 24 hours a day astern part of Service area includes the southe of Festus, Jefferson County – the municipalities bout 180 Crystal City, Herculaneum, Pevely – a square miles of building Four station houses (in the process two more houses.) 9 More than 5,342 calls in 200
Valle Ambulance District
21 full-time paramedics and EMTs 13 part-time staff duty 24 Three fully equipped ambulances on .) ces hours a day. (two back up ambulan its of DeSoto Service area includes the city lim western and Hillsboro and all of the surrounding on County and southwestern portions of Jeffers – about 250 square miles Three station houses 9 More than 3,200 calls in 200
St. Francois County Ambulance District
EMTs 38 full-time Paramedics, five full-time and a maintenance mechanic d EMTs. More than 35 part-time Paramedics an y 24 hours 13 fully equipped ambulances on dut s time a day. (six of them in our high peak and five at night) Three station houses re miles of Service area covers all 454 squa St. Francois County. 9 More than 10,000 calls in 200
52 RSVP Health | www.rsvphealth.com
EMS is a key mem of Heart Team at Jefferson Regiona
M
ost heart attacks start slowly, with mild pain or discomfort; Often people affected aren't sure what's wrong and wait too long before getting help. You may feel pressure, squeezing, fullness or pain in the chest. You could experience discomfort in one or both arms, the back, neck, jaw or stomach. You may notice shortness of breath, a cold sweat, nausea or lightheadedness. Fortunately, world class heart care is close to home at Jefferson Regional Medical Center. Your care begins soon after you dial 9-1-1 and emergency medical services (EMS) arrive on the scene. As a vital component of the care team, the men and women of Joachim-Plattin, Valle and St. Francis County ambulance districts are your lifeline to the hospital. “Upon arrival we assess the patient to see what kind of pain they are having,” said Curt Stueve, Administrator of Joachim-Plattin Ambulance District. “We immediately run a 12-lead EKG if the patient is having any kind of chest discomfort or pain. Thanks to remarkable on-board technology, we can capture and transmit the EKG information instantly to Jefferson Regional.” The electrocardiogram (EKG) provides information on electrical activity of the heart through electrodes attached to the skin. The information is sent via the Internet to Jefferson Regional where the attending physician can review it
immediately and determin having a STEMI (ST eleva infarction) — a heart atta the EKG in the field minut and saving minutes is crit of a heart attack. “At that point the EMS specific protocol that has with Jefferson Regional M said Dave Tetrault, Admin Francois County Ambulan “For every patient who is a potential heart attack, t immediately draws blood, and gives the patient asp medication as appropriate The patient is rushed t Department at Jefferson while en route, ambulance in constant contact with t the medical center staff o the patient’s condition. “Treatment continues t the entire trip to the hosp Williams, Administrator of District. “We continue mo the patient’s blood pressu saturation and EKG. The m if there has been any cha us of any life threatening Stabilizing the patient and comfortable as possible a Upon arrival the patien transferred to the critical in Jefferson Regional’s Em Department.
mber
al
ne if the patient is ation myocardial ack. By starting tes are saved, tical in the case
personnel have a s been developed Medical Center,” nistrator of St. nce District. experiencing the EMS team , starts IVs pirin and pain e.” to the Emergency Regional, and e personnel stay the ER, apprising of any change in
throughout pital,” said Joe f Valle Ambulance onitoring ure, oxygen monitors tell us ange that alerts arrhythmias. d keeping them as are top priorities.” nt’s care is care team mergency
As Members of the Heart Team at Jefferson Regional Medical Center …
“We are achieving the goal of having a healthier community. Our residents are getting better care because we are coming to a hospital with a heart center that can treat the patient closer to home. Patients should know that with a heart attack, time is of the essence; time is muscle. Jefferson Regional can provide the heart services for a positive outcome — closer to home.” Dave Tetrault St. Francois County Ambulance District
“It’s all about the team. We are here for the community. We want to continue to provide the patient with the best service possible. By teaming with Jefferson Regional, it’s just good for everybody – the patient and the community. The earlier recognition and treatment make all the difference in a patient’s outcome and opportunity to enjoy a fuller and richer life.” Curt Stueve Joachim-Plattin Ambulance District
“We have a great working relationship with all of the staff at Jefferson Regional. We have our EMS meetings once a month with the ER nurses and physicians, as well as the other EMS providers to develop the best possible service for our patients and communities. Like the ambulance districts that serve our communities, I have seen the hospital grow by leaps and bounds. The hospital’s recent Chest Pain Center accreditation is an example of that ongoing commitment.” Joe Williams Valle Ambulance District
RSVP Health | www.rsvphealth.com 53
Health Savings Accounts | By Dr. Rodney D. Gross Ph.D., Randy Ressel
Health Savings Accounts (HSA) were signed into law by President Bush on December 8, 2003 and are accounts that are design are to help individuals save for future qualified medical and retiree health expenses on a tax-free basis. There are certain advantages to putting money into these accounts. Recently with all the attention the media and politicians have placed on your health care, it has all of us rethinking about ourselves, our families and our “Return on Investment (R.O.I.).” I think this is a positive thing because it puts us in a position to have to empower ourselves to be your own health care expert. The majority of the people in the media and elected officials do not have the expertise or experience on health and wellness issues. They get their information the same way I try to empower you to do, except they tell people to go find the information for them, I give you the resources so you can become better
Consumer-Driven Health Plans Help Decide How Health Dollars Are Spent While Helping Improve Health Status By Randy Ressel Regional Vice President, Sales Anthem Blue Cross and Blue Shield in Missouri Rising costs are prompting many consumers to find new solutions to the problem of health care affordability. One answer increasingly being adopted by the cost-conscious is consumerdriven health plans (CDHP). Approximately 10 million nationwide choose these high-deductible options and pay far less than they would under more traditional plans. Moreover, the majority of these members enroll in flexible tax-free Health Savings Accounts (HSAs) whose funds can be withdrawn for qualified medical expenses, allowing consumers to “drive” their plan by deciding how their health dollars are spent.
54 RSVP Health | www.rsvphealth.com
informed because it is “your” health and wellness, your “money/tax dollars”, “your” Return on Investment. For me, when asked about HSA’s, I come in from the approach of educating people on the “true” cost of health care. This is the core of understanding how HSA’s work. What I have done is to find “other leading health and wellness experts” who understand this core of HSA’s. One basic source is a free tri-fold pamphlet from the U.S. Treasury website (http://www.ustreas. gov/offices/public-affairs/hsa/pdf/HSA-Tri-foldenglish-09.pdf) and the other is Randy Ressel of Anthem Blue Cross and Blue Shield of Missouri. After having about an hour conversation with him on HSA’s, his message and expertise was right what I was looking for in understanding not only the “core” but also all-inclusive education and awareness. – Dr. Rodney D. Gross, Ph.D.
What is different about today’s consumer is they are looking for plans that include proactive care management and wellness programs, helping them get the most out of their benefits. Consumers are searching for plans that do more than just pay their medical bills. They’re looking for medical plans that help them navigate the health care system and manage chronic conditions, provide more value for money, and help them improve and maintain their health in the long run. Anthem’s consumer-driven health plans empower members to become engaged in their health and navigate the health care system effectively. The plan options include: An HSA-compatible plan offers maximum cost effectiveness. Employees make pre-tax contributions to their accounts. Your company can contribute, too. You can even offer rewards for healthy behaviors. The funds do not have to be used for first dollar coverage, so your employees choose when to use them. Plus, unused funds roll over from year to year. Through a partnership with a financial institution, we integrate the
RSVP Health | www.rsvphealth.com 55
Health Savings Accounts | By Dr. Rodney D. Gross Ph.D. and Randy Ressel
financial and health administration of the plan, so you and your employees have a single point of contact for almost every aspect of the plan. An HIA can help you introduce the idea of consumer-driven health care to your employees. The health accounts are solely funded by rewards your employees earn when they do things like quitting smoking or managing their weight. These funds offer first dollar coverage and roll over if not used. Contributions are made by either your company or by Anthem. In an enriched HIA, employees receive annual allocations to their health accounts. These funds offer first dollar coverage, and unused funds roll over from year to year, which can help reduce potential out-of-pocket expenses. Plus, your employees can earn additional dollars for taking steps to improve their health. The only difference with this plan: Anthem funds the health accounts. In fact, surveys are showing that CDHP plan members see positive impacts to their health. The results show that members in their first year in a CDHP have lower trend than members in who remain in traditional plans. And members enrolled in a CDHP plan yearover-year continue to see lower trend than members in traditional plans. We also see that our plan members utilize preventive care services more often, have fewer ER and office visits, and increased their use of lower cost prescription drugs. We feel that these changes in behavior will result in even greater long-term savings for employers. Powerful online decision support tools and personal health coaching helps consumers learn more about their health care treatment and cost options. For example, when members complete an online health assessment, enroll in a program with a health coach, successfully complete a smoking cessation program or make other healthy lifestyle choices, they will receive tangible incentives and rewards in their HSA or HIA. In the end, CDHP plans offer a flexible, affordable option that puts the consumer in the driver’s seat when it comes to his or her health care. Consumer-driven health plans make navigating the system and managing chronic conditions easier financially and practically. For the 10 million people who enroll in Health Savings and Retirement Accounts, the benefits speak for themselves.
Dramatic Growth of HSA’s In 2004 -
438,000
Individuals covered in November 2004 by HSA-type insurance plans (AHIP)
In 2005 -
3,200,000
Seven fold increase to individuals covered by HSA type insurance plans (AHIP)
$1,000,000,000
Dollars invested in HSAs by Americans.
Predicted for 2010 -
14,000,000
Treasury Department projection of HSA policies (covering 25 to 30 million people)
RSVP Health | www.rsvphealth.com 57
“I think this is the beginning of a beautiful friendship”
- Rick, Casablanca
The Education Continues: Community Health Care Forum August 14, 6pm at Mineral Area College More information and updated articles at rsvpHealth.com Find us on Facebook and Twitter
58 RSVP Health | www.rsvphealth.com
Special Advertisement Section
Health Care Resource Guide Your community resource to health care providers.
RSVP Health | www.rsvphealth.com 59
Ladies First OB/GYN | Obstetrics & Gynecology “We would love the opportunity to provide you with excellent health care services.”
Dr. John Grechus Dr. John Grechus, a Missouri Native, attended the University of Missouri in Kansas City for his undergraduate training as well as medical school. His residency in family practice at the University of Texas in Houston developed into his love for delivering babies. His obstetrics and gynecology residency was back at his alma mater, Truman Medical Center in Kansas City, Missouri. Fresh out of residency training, in 1989, he moved his family to Farmington, which he now calls home. He has been married to Penny for almost 30 years and has raised two children, Joe and Katie who are the joys of his life. Dr Grechus served 5 years on the BJC Medical Group Board in the 1990’s and then decided to venture to private practice in 2001. Since being in private practice, he has served as the division chairman of both Mineral Area Regional Medical Center and Parkland 60 RSVP Health | www.rsvphealth.com
Ladies First OB/GYN 1105 West Liberty, Suite 3002 Farmington, MO 63640 Phone: 573-756-9107 Fax: 573-756-9630 www.ladiesfirstobgyn.com
Health Center. He was a founding board member of the Parkland Pregnancy Resource Center in Park Hills, which provides pregnancy help, education and abortion alternatives. “Providing women’s health care now to the second generation of my patients in the Farmington and surrounding areas has been a truly wonderful life.” Outside of work, Dr Grechus enjoys music, movies, travel and just being himself in the backyard pool during the summer and reading by the wood fireplace in the winter. He would like to be your delivering doctor. Dr. Kimberly Hartel Dr. Kimberly Hartel was born here at Parkland Health Center and was raised in Potosi. She attended University of Missouri in Kansas City for both her undergraduate training as well as her medical school. Her family practice residency was at Cox Family Medicine
Special Advertisement Section
John J. Grechus, M.D.; Danielle N. Carron, M.D.; Kimberly L. Hartel, M.D.; Mary E. Crecelius, M.S.N.,
Residency in Springfield. Dr. Hartel is a board certified Family Physician who also has training in Obstetrics. Her practice focuses on pregnancy, women’s health, pediatrics and minor procedures as well as a wide range of primary care services. Dr. Hartel recently returned to Farmington with her husband Craig and their son Brayden to begin practice. Outside of work, Dr. Hartel enjoys horseback riding, reading and spending time with her family. When asked about returning to the area, Dr. Hartel replied, “Returning to Farmington has been an amazing experience. Being able to practice in the community where I was raised is incredibly rewarding. Working with our wonderful patients throughout their pregnancy and caring for their children afterwards is definitely the highlight of my career.” Dr. Hartel would love the opportunity to be your family physician. Mary Crecelius, M.S.N. Mary Crecelius, M.S.N., Women’s Health Nurse Practitioner at-
tended Avila University in Kansas City where she obtained her Bachelors of Science in Nursing. She worked at St. Lukes Hospital in Kansas City before moving to Farmington with her husband Robert. In Farmington, Mary has worked at both Mineral Area Regional Medical Center and Parkland Health Center gaining experience in the emergency, surgery and obstetrics departments. She eventually was the nurse manager for Parkland Health Center’s obstetrical department for 5 years before becoming a nurse practitioner. Mary has practiced as a Women’s Health Nurse Practitioner since 1997 and has enjoyed every moment. She feels that she gets to work with her friends and has been amazed and humbled by the courage, joy, perseverance and wisdom each of her patient’s stories has imparted to her. Outside of work, Mary enjoys having time with her husband and their 3 grown children. She enjoys running, bicycling, hiking, yoga, reading and anything outdoors. RSVP Health | www.rsvphealth.com 61
Special Advertisement Section
Danielle N. Carron, M.D. | Obstetrics & Gynecology Announcing a new addition to Ladies First OB/GYN to further meet your health care needs! I am accepting new patients at Ladies First OB/GYN. Primary Specialty: Family Medicine Secondary Specialty: Obstetrics & Gynecology Medical Education: Doctor of Medicine : 2007 University of Missouri Kansas City; Kansas City, Missouri
62 RSVP Health | www.rsvphealth.com
Ladies First OB/GYN
Ladies First OB/GYN 1105 West Liberty, Suite 3002 Farmington, MO 63640 Phone: 573-756-9107 Fax: 573-756-9630 www.ladiesfirstobgyn.com
Residency: Family Medicine Residency : 2010 CoxHealth; Springfield, Missouri Board Certifications: Family Medicine : 2010 Board Eligible; American Board of Family Medicine In Practice Since: 2010
Special Advertisement Section
Dr. Lisa Long, Ph.D. | Chiropractic Long Chiropractic, INC 307-E East Karsch Blvd, Farmington, MO 63640 Phone: 573-760-1515 www.longchiropracticinc.com
Dr. Lisa R. Long is a Chiropractic Physician who has been in private practice for 21 years. Dr. Long earned her Doctorate of Chiropractic degree from Logan College of Chiropractic in Chesterfield, MO. She offers a natural approach to health care in areas of family care, personal injury cases, sports & work injuries, and custom foot orthotics. Sub-services include sports physicals, and DOT & non-DOT physicals. Dr. Long is pleased to announce the immediate offering of “low level laser therapy” technology in her practice in conjunction with chiropractic care. This laser therapy is advanced and effective, and is part of Long Chiropractic’s continued investment in advanced technologies and progressive procedures in the chiropractic field.
Long Chiropractic
Laser therapy is advanced and effective and is part of Long Chiropractic’s continued investment in advanced technologies... LASER THERAPY HAS SHOWN TO BE EFFECTIVE FOR: • Pain Management • Spinal conditions relating to irritated & swollen discs, herniated discs, etc • Neurological pain • Joint and tendon conditions such as painful/swollen/stiff arthritic joints and tendonitis • Soft tissue injuries such as strains & sprains and trigger points • Chronic non-healing wounds • Pre and post surgical treatment • Call us today to make your appointment for better health & wellness the natural way. For more information about Long Chiropractic Wellness & Laser Center, visit Dr. Long’s website @ www.longchiropracticinc.com. RSVP Health | www.rsvphealth.com 63
Special Advertisement Section
Midwest Health Group Convenient Care | Convenient Care
No Appointment Needed! Convenient Care for Busy People. Midwest Health Group’s Convenient Care realizes that our communities we serve are busier than ever. As individuals and families worry about work, kids, schools, shopping and a whole lot more, we further realize that there are times when you or a family member becomes ill. We know how difficult it is sometimes to stop, make a call and try to get into your Primary Care Provider and in addition, we understand the struggles to walk into an Emergency Room for non-life threatening illnesses. Even if you have family or friends visiting the area, we are here for them. Maybe you are just travelling through or visiting the area, we are here for you. By understanding you, your schedules and your budget, we enhance unexpected and inconvenient health issues when they may arise through total convenience for you. We offer you access with expanded hours, no phone calls or appointments necessary, minimal 64 RSVP Health | www.rsvphealth.com
Midwest Health Group Convenient Care 507 W. Pine St., Farmington, MO 63640 Phone: 573-454-2466 www.midwestconvenientcare.com
to no wait times and comprehensive services that include on site lab & x-ray services, just to name a few, at a much reduced rate than a Emergency Room Visit for non-life threatening illnesses. In addition, our staff of Physicians and Nurse Practitioners is readily available to see you for Minor Injuries, Flu Symptoms, Rashes, Colds, Sore Throats, Insect bites, Urinary Tract Infections, Minor Lacerations and Stomach related problems, etc. It is not our intention to replace your regular Primary Care Provider, but to offer you options when they may not be available. We will make every effort to ensure that your visit and services performed be shared with your regular Primary Care Provider with your consent no matter where they may be located.
If you are a new patient, we offer you the same services with additional medical management and comprehensive care (Diabetes, High Blood Pressure, Arthritis, Acid Reflux, etc) of a Primary Care Provider with specialties within our group such as Cardiology, ENT and Gastrointestinal to name a few. By incorporating our network into your health, we ensure continuity of care and always maintaining medical management of our patients. Striving to enhance your health care experience, we are always trying not to add to your busy schedule of having to drive in all directions to see Specialists or have Ancillary Test done, therefore, we always have your “convenience” in mind by incorporating other specialties and testing equipment. If you are a business, we offer you and your employee’s comprehensive services as mentioned above for Workman’s Compensa-
tion Benefits when they may arise. In addition, we offer Drug Screenings for Pre-Employment & Post-Accidents and Work Physicals to include Department of Transportation (D.O.T) Physicals. We accept most Insurance, Medicare, Medicaid and Workman’s Compensation. We realize that not everyone has insurance and having that in mind, we proudly offer our fees and tests at a very reasonable rate compared to what you may pay at an Emergency Room. Our services are always available to you at those inconvenient times and if you were looking for a Primary Care Provider, it would be our pleasure. We invite you to stop in, visit our facility, and please feel free to contact us by phone, email and or visit our website, www.midwestconvenientcare.com. RSVP Health | www.rsvphealth.com 65
Special Advertisement Section
USA Drug | Pharmacy
Committed to improving your quality of life.
USA Drug is about commitment to you and the communities we serve. We strive to me more than just a drug store that fills prescriptions. Our goal is to be an all-inclusive resource for the betterment of your well-being and a leading economic factor in communities. Outside the realm of filling prescriptions, we offer free delivery of prescription directly to you, Grief & Loss Service, Spend down Assistance, Medicare Part D Assistance, Full Respiratory Dept-(filling 66 RSVP Health | www.rsvphealth.com
USA Drug 120 E. Karsch Farmington, MO 63640 Phone: 573-756-6421 Fax: 555-555-5555 www.usadrugmissouri.com
your Oxygen on site) & two Respiratory Therapists on staff, Mobility & Diabetic supplies. Our staff of Registered Nurses and other health & wellness experts are on the forefront of education, awareness and wellness in the form of Health Fairs, Shot Clinics, Blood Pressure Checks, Cholesterol Checks, Sugar Testing, etc. You will find us in Hospitals, Doctor’s Clinics, and Nursing Homes making your overall health care experience less stressful.
In addition to making this commitment, through added services, we increase the economies of our communities where we are present through things like construction, real estate, tax revenue and jobs. You and your communities are our foremost concern and if you have not experienced our commitment or would like to know how involved we are in your well-being, come see us.
Locations: Desloge | USA Drug 1142 N. Desloge Drive Farmington | USA Drug 120 E. Karsch 1107 West Liberty, Room 1002 Ironton | Arcadia Valley Drug 124 W. Russell Street Bonne Terre | Allen St. Apothecary 36 N. Allen Street RSVP Health | www.rsvphealth.com 67
Clayton Sleep Institute | Joseph M. Ojile, M.D.
Better Sleep. Better Life. Sleep affects every aspect of health; it is vital to our sense of wellbeing. With more than 40 million Americans suffering from some sort of sleep disorder, you cannot afford another bad night’s sleep. Clayton Sleep Institute (CSI) is a leading independent organization founded, directed and managed by expert medical research and technology professionals dedicated to all aspects of sleep medicine and healthy sleep.
68 RSVP Health | www.rsvphealth.com
Clayton Sleep Institute 2531 S Big Bend Maplewood, MO 63143 Phone: 314-645-5855 www.claytonsleep.com
The Sleep Clinics Owned and managed by Clayton Sleep Institute, our Sleep Clinics diagnose patients with sleep disorders such as sleep apnea. Patients stay overnight in the Sleep Clinic’s comfortable and supportive environment where their sleep is monitored and measured by highly trained specialists using state-of-the-art technology. The Insomnia Center An independent insomnia clinic with a strong patient focus. The Insomnia Center is in the national forefront of insomnia diagnosis and treatment.
Special Advertisement Section
Joseph M. Ojile, M.D.; Jeffrey D. Harris, M.D.; Kirk A. Nelson, D.O.
The Research Center At Clayton Sleep Institute, we lead and participate in the highest levels of sleep research. This science informs all our endeavors to help patients achieve better health through better sleep. The Research Center designs and directs research in sleep medicine and has been awarded dozens of research projects by medical device and pharmaceutical companies, the federal government and health foundations. The Midwest Updates in Sleep Medicine Clayton Sleep Institute sponsors this annual symposium on topical sleep medicine and sleep disorders. The Midwest Updates in Sleep
Medicine faculty features national leaders in sleep medicine and attracts attendance by physician, psychologists and health care professionals. Continuing medical education accreditation is an additional benefit of the curriculum at each Midwest Updates in Sleep Medicine conference. Through these practices, Clayton Sleep Institute creates a 360-degree approach to complex physiological, behavioral, emotional and communal aspects of sleep medicine and sleep health. Through each practice, the Clayton Sleep Institute team strives to reach the same goal for each patient, and for all people.
RSVP Health | www.rsvphealth.com 69
Special Advertisement Section
Paul Moniz, D.O.; Guy Roberts, D.O. “Brighter future begins with better health care.” Welcome to a new way of thinking about health care for you and your family. Midwest Health Group is committed to providing you with the tools you need to maximize good health, through information, education and lastly, medication. We promise to
70 RSVP Health | www.rsvphealth.com
Midwest Health Group Midwest Health Group 508 W. Pine St., Farmington, MO 63640 Phone: 573-747-1510 Fax: 573-747-1512 www.midwesthealthgroup.com
listen to you, and help you find the answers to your concerns. We promise that if we do not know the answer, we will find someone who does. You see, health care today is way too complicated so we look to provide simpler solutions. Health care solutions...it’s what we’re about.
RSVP Health | www.rsvphealth.com 71
Fresh faces. Superb train
Hamid Bashir, M.D. Board Certified Rheumatology
Call today for an appointment
636-933-2900
Nicole Ducharme, D.O. E. William Kennen Jr., D.O. Clarence Temple, M.D. Board Certified Endocrinology
Board Certified Orthopaedic Surgeon
Board Certified Orthopaedic Surgeon
Call today for an appointment
Call today for an appointment
Call today for an appointment
636-933-2900
636-933-8050
636-933-8050
At Jefferson Health System we recognize the healthcare needs of the com physicians. In addition to these specialists we will add a dermatologist, this year. All of our physicians are accepting new patients, so call toda
For a complete list of Jefferson Health S
www.jhsmo.com
636-933-1000
|
1-
ning. Open schedules.
Meredith Hartle, D.O.
Joanne Waltman, M.D.
Lawrence J. Billy, M.D. Wound Care Center Medical Director
Board Certified Infectious Diseases Specialist
Call today for an appointment
Call today for an appointment
Call today for an appointment
Call today for an appointment
Board Certified Family Practice
636-933-2900
Board Certified Internal Medicine
636-933-2900
636-933-1163
Diane Marchesani, D.O.
636-933-7900
mmunities we serve and continue to recruit high-quality, board certified pediatrician, endocrinologist, and family practice physician to our staff ay for an appointment or ask your primary care physician for a referral.
System physicians visit www.jhsmo.com.
-888-931-JRMC (5762)
We are your hospital.
Health Care Health care Providers List
Providers List
Allergist
Allergist / Asthma
Bruce Walz, MD Jefferson Regional Medical Center Festus , MO P. 314-577-8815 www.jeffersonmemorial.org
John Marcum, M.D. Southeast Missouri Allergy/ Asthma Practice Park Hills, MO P. 573-431-5303
Elyra Figueroa, MD Jefferson Regional Medical Center Festus , MO P. 314-821-2100 www.jeffersonmemorial.org Ernesto Ruiz-Huidobro, MD Jefferson Regional Medical Center Festus , MO P. 314-821-2100 www.jeffersonmemorial.org Maria Sabio, MD Jefferson Regional Medical Center Festus , MO P. 314-821-2100 www.jeffersonmemorial.org Kevin Boatwright, M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-1744 www.parklandhealthcenter.org
Christopher Speidel, MD Jefferson Regional Medical Center Festus , MO P. 636-931-2961 www.jeffersonmemorial.org
Jung Lee, MD Jefferson Regional Medical Center Festus , MO P. 636-937-0817 www.jeffersonmemorial.org
David Harshman, MD Jefferson Regional Medical Center Festus , MO P. 636-931-2961 www.jeffersonmemorial.org
Linda Stronach, MD Jefferson Regional Medical Center Festus , MO P. 636-931-2961 www.jeffersonmemorial.org
Karen Lamb, M.D. Audiology & Hearing Center of Farmington Farmington, MO P. 573-756-0500 www.farmingtonhearing.com
Dilip Patel, MD Jefferson Regional Medical Center Festus , MO P. 314-849-0111 www.jeffersonmemorial.org
Maged Haikal, MD Jefferson Regional Medical Center Festus , MO P. 314-205-6699 www.jeffersonmemorial.org
Cardiologist
Gregory Botteron, MD Jefferson Regional Medical Center Festus , MO P. 314-692-2807 www.jeffersonmemorial.org
Mark Chin, MD Jefferson Regional Medical Center Festus , MO P. 636-931-2961 www.jeffersonmemorial.org
Harvey Serota, MD Jefferson Regional Medical Center Festus , MO P. 314-741-0911 www.jeffersonmemorial.org
Michael Fleissner, MD Jefferson Regional Medical Center Festus , MO P. 636-931-2961 www.jeffersonmemorial.org
Jeffrey Reese, MD Jefferson Regional Medical Center Festus , MO P. 636-933-5055 www.jeffersonmemorial.org
Michael Goldmeier, MD Jefferson Regional Medical Center Festus , MO P. 314-645-6450 www.jeffersonmemorial.org
Audiologist
Andre Bouhasin, MD Jefferson Regional Medical Center Festus , MO P. 636-931-7101 www.jeffersonmemorial.org Bassam Roukoz, MD Jefferson Regional Medical Center Festus , MO P. 636-933-5055 www.jeffersonmemorial.org
74 RSVP Health | www.rsvphealth.com
Rajiv Handa, MD Jefferson Regional Medical Center Festus , MO P. 314-965-9586 www.jeffersonmemorial.org Rami Akel, MD Jefferson Regional Medical Center Festus , MO P. 636-933-5055 www.jeffersonmemorial.org Randy Johnson, MD Jefferson Regional Medical Center Festus , MO P. 314-781-8082 www.jeffersonmemorial.org Zia Ahmad, M.D. Jefferson Regional Medical Center Festus , MO P. 314-835-0001 www.jeffersonmemorial.org Billy Hammond, M.D. Cardio Vascular Consultants of Cape Girardeau Cape Girardeau, MO P. 573-334-6008 www.cvccape.com Paul Hocomb, M.D. Cardio Vascular Consultants of Cape Girardeau Cape Girardeau, MO P. 573-334-6008 www.cvccape.com
Allen Spitler, M.D. Cardio Vascular Consultants of Cape Girardeau Cape Girardeau, MO P. 573-334-6008 www.cvccape.com C.R. Talbert, M.D. Cardio Vascular Consultants of Cape Girardeau Cape Girardeau, MO P. 573-334-6008 www.cvccape.com William Southworth, M.D. Heart Health Center Farmington, MO P. 573-760-1111 Antoine Adem, M.D. Midwest Health Group Cape Girardeau, MO P. 573-747-1510 www.midwesthealthgroup.com Cardiology Diagnostics Farmington, MO P. 573-701-0222 Raffi Krikorian, M.D. Farmington, MO P. 573-756-5298 James Spadaro, M.D. Fredericktown, MO James Craft, M.D. Fredericktown, MO
Cardiovascular Surgeon
William LaFoe, M.D. Cardio Vascular Consultants of Cape Girardeau Cape Girardeau, MO P. 573-334-6008 www.cvccape.com
Edward Bender, M.D. Cape Thoracic & Cardiovascular Surgery Cape Girardeau, MO P. 573-331-3155 www.cvsurgery.com
David Law, M.D. Cardio Vascular Consultants of Cape Girardeau Cape Girardeau, MO P. 573-334-6008 www.cvccape.com
Bruce Jones, M.D. Cape Thoracic & Cardiovascular Surgery Cape Girardeau, MO P. 573-331-3155 www.cvsurgery.com
Kenneth Retter, M.D. Cardio Vascular Consultants of Cape Girardeau Cape Girardeau, MO P. 573-334-6008 www.cvccape.com
William Tung, M.D. Cape Thoracic & Cardiovascular Surgery Cape Girardeau, MO P. 573-331-3155 www.cvsurgery.com
Gabe Soto, M.D. Cardio Vascular Consultants of Cape Girardeau Cape Girardeau, MO P. 573-334-6008 www.cvccape.com
Jogn Wiggans, M.D. Cape Thoracic & Cardiovascular Surgery Cape Girardeau, MO P. 573-331-3155 www.cvsurgery.com
Randy Brown, M.D. Cardiac & Vascular Surgeons of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7870 www.southeastmissouri hospital.com William Ogle, M.D. Cardiac & Vascular Surgeons of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7870 www.southeastmissouri hospital.com Muali Macheria, M.D. Cardiac & Vascular Surgeons of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7870 www.southeastmissouri hospital.com Darryl Ramsay, M.D. Cardiac & Vascular Surgeons of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7870 www.southeastmissouri hospital.com
Daniel Huck Potosi Chiropractic Life Center Potosi, MO P. 573-438-5801
Steven McAdams Arcadia Valley, MO P. 573-546-7517 Timothy Wulfert Wulfert Chiropractic & Acupuncture, PC Farmington, MO P. 573-756-9292 Bismarck Chiropractic Bismark, MO P. 573-734-1100 Desired Health Chiropractic Farmington, MO P. 573-756-6496
Robart Chiropractic Care Potosi, MO P. 573-438-7200
Dentist
Daniel Young Young Chiropractic Park Hills, MO P. 573-331-3155 Darrin Bauer Bauer Chiropractic & Acupuncture Farmington, MO P. 573-756-8700
Lisa Long Long Chiropractic Inc Farmington, MO P. 573-760-1515 www.longchiropracticinc.com
Stephen Orr Midwest Orthopedic Center Farmington, MO P. 573-756-3400
Missing Peace Farmington, MO P. 573-431-8009
Daniel Reiter Reiter Chiropractic Bonne Terre, MO P. 573-358-7655 www.reiterchiro.com
Kevin Roberts Madison County Chiropractic Fredericktown, MO P. 573-783-3188
Philip Wilfert Family Chiropractic Office Fredericktown, MO P. 573-783-5530
Huck Chiropractic Life Center Desloge, MO P. 573-518-0608
Chiropractor
Joseph Huck Potosi Chiropractic Life Center Potosi, MO P. 573-438-5801
Mark Medley Farmington Chiropractic Center Farmington, MO P. 573-756-0056
Joseph Cangelosi, DDS Bismark, MO P. 573-734-6082 Michael Correale, DDS Park Hills, MO P. 573-431-5155 www.correaledentistllc.com Gary Crowley, DDS Parkland Dental Arts Farmington, MO P. 573-756-1236 Michael Edgar, DDS Park Hills, MO P. 573-431-5566 Tim O’Bryan, DDS Farmington, MO P. 573-756-4344
RSVP Health | www.rsvphealth.com 75
Health care Providers List
Michael Shapiro, MD Jefferson Regional Medical Center Festus , MO P. 314-865-9586 www.jeffersonmemorial.org
Health care Providers List
James Shaner, DDS Farmington Dental Care Farmington, MO P. 573-756-4245 www.farmingtondentalcare.com Kenneth Haas, DMD Fredericktown, MO P. 573-783-5573 John Jackson, DDS Farmington, MO P. 573-756-6415 Thomas LaMartina Westmount Dental Arts Farmington, MO P. 573-760-0440 www.westmountdentalarts.com E W Lake, DDS Potosi, MO P. 573-438-6277 Charles McHenry, DDS Ironton, MO P. 573-546-3368 Steven Monrotus, DDS Farmington, MO P. 573-756-7500 Debra Morgan Debra Morgan LLC Bonne Terre, MO P. 573-358-7566 Jason Oberkfell Westmount Dental Arts Festus, MO P. 636-937-6565 B L Ogborn Oral & Maxillofacial Surgery Farmington, MO P. 573-756-1707 www.drogborn.com Douglas Ross Farmington, MO P. 573-756-5760 Kent Sadler Ste Genevieve, MO P. 573-883-5781 Paul Vilmer Potosi, MO P. 573-438-2159 Guy Walker Fredericktown, MO P. 573-783-4100 Timothy McMann Westmount Dental Arts Farmington, MO P. 573-760-0440 www.westmountdentalarts.com
Robert Greenwald Debra Morgan LLC Bonne Terre, MO P. 573-358-7566 Joseph Engel Debra Morgan LLC Bonne Terre, MO P. 573-358-7566 Michael Wiley Gental Dental Care Park Hills, MO P. 573-431-6021 Gary Crowley, DDS Parkland Dental Arts Farmington, MO P. 573-756-1236 Gregory Pernoud Oral & Maxillofacial Surgery Festus, MO P. 636-937-1515 www.lasererase.com
Dermatologist Darrell Griffin, M.D. Southeast Missouri Dermatology Farmington, MO P. 573-760-8811 Samantha McNail, M.D. Southeast Missouri Dermatology Farmington, MO P. 573-760-8811
Dialysis Farmington Dialysis Center Farmington, MO P. 573-760-1049 www.davita.com Fredericktown Dialysis Clinic Fredericktown, MO P. 573-783-2089 www.davita.com
Endocrinologist Nawras Makhsida, M.D. Jefferson Multi-Specialty Group Festus, MO P. 800-781-0049 www.jeffersonmemorial.org Wu Wen, M.D. Endocrinology Associates of SE Missouri Hospital Cape Girardeau, MO P. 573-334-6169 www.southeastmissouri hospital.com
76 RSVP Health | www.rsvphealth.com
Robert Kimmel, M.D. Endocrinology Associates of SE Missouri Hospital Cape Girardeau, MO P. 573-334-6169 www.southeastmissouri hospital.com Nicole Ducharme, D.O. Jefferson Multi-Specialty Group Festus, MO P. 800-781-0049
Endodontist Charles Clarke Farmington, MO P. 573-756-6868
Ear / Nose / Throat Justin Roberts, D.O. Farmington Ear, Nose & Throat Farmington, MO P. 573-756-8888 Keith Bonacquisti, M.D. Festus, MO P. 636-937-2386 Stanley Thawley, M.D. Farmington, MO P. 800-437-5430 Sean Bailey, M.D. Fredericktown, MO
Family Practice David Stansfield, DO Jefferson Regional Medical Center Festus, MO P. 636-789-3941 www.jeffersonmemorial.org Edward Myles, MD Jefferson Regional Medical Center Festus, MO P. 636-789-2722 www.jeffersonmemorial.org Jim C. Sanders, DO Jefferson Regional Medical Center Festus, MO P. 636-586-4747 www.jeffersonmemorial.org John E. Emmons, DO Jefferson Regional Medical Center Festus, MO P. 573-546-0184 www.jeffersonmemorial.org Kenneth Kilian, MD Jefferson Regional Medical Center Festus, MO P. 636-933-9300 www.jeffersonmemorial.org
Kevin Sides, DO Jefferson Regional Medical Center Festus, MO P. 636-937-3611 www.jeffersonmemorial.org Michael Patterson, DO Jefferson Regional Medical Center Festus, MO P. 636-464-4000 www.jeffersonmemorial.org Padmini Charles, MD Jefferson Regional Medical Center Festus, MO P. 636-937-8989 www.jeffersonmemorial.org Phillip Rowden, MD Jefferson Regional Medical Center Festus, MO P. 636-586-4747 www.jeffersonmemorial.org Shawndra Brown-Foote, M.D. Jefferson Regional Medical Center Festus, MO P. 800-781-0049 www.jeffersonmemorial.org Solomon Noguera, M.D. Jefferson Regional Medical Center Festus, MO P. 636-931-3667 www.jeffersonmemorial.org Steven Crawford, MD Jefferson Regional Medical Center Festus, MO P. 636-586-6685 www.jeffersonmemorial.org Patrick O’Hara, M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org Maria Ambalong, M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org Abegaile santiago, M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org Gene Draves, M.D. Draves Family Medicine Festus, MO P. 636-937-2700 Jeffrey Draves, M.D. Draves Family Medicine Festus, MO P. 636-937-2700
Meredith Hartle Jefferson Multi-Specialty Group Festus, MO P. 800-781-0049 Lorna Stookey, M.D. Madison Medical Center Fredericktown, MO P. 573-783-4111 www.madisonmedicalcenter.net Eric Davis, D.O. Madison Medical Center Fredericktown, MO P. 573-783-4111 www.madisonmedicalcenter.net Paul Moniz, D.O. Midwest Health Group Farmington, MO P. 573-747-1510 www.midwesthealthgroup.com Guy Roberts, D.O. Midwest Health Group Farmington, MO P. 573-747-1510 www.midwesthealthgroup.com Stephanie Moniz, D.O. Midwest Health Group Farmington, MO P. 573-747-1510 www.midwesthealthgroup.com James Buchanan, D.O. Farmington, MO P. 573-760-9337 Henry Steele, D.O. Arcadia Valley, MO P. 573-546-6000 Phillip Beyer, D.O. Beyer Medical Group Fredericktown, MO P. 573-783-8875 Dennis Sumski, D.O. Farmington, MO P. 573-756-4200 Stephen Forsythe, D.O. Quality Healthcare Inc Desloge, MO P. 573-431-2829
Gastroenterologist Matthew Gaeta, M.D. Gastroenterology Services of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7910 www.southeastmissouri hospital.com
Trygve Honaas, M.D. Gastroenterology Services of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7910 www.southeastmissouri hospital.com
Roberto Martinez, M.D. Hematology - Onocology Associates of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7970 www.southeastmissouri hospital.com
MARMC Home Health Services Farmington, MO P. 573-756-6199
M. Jamal, M.D. Bonne Terre, MO P. 866-937-0200
James Mosley, M.D. Hematology - Onocology Associates of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7970 www.southeastmissouri hospital.com
Premier Home Health Care Park Hills, MO P. 573-431-3134
Krishhnamohan Basarakodu, M.D. Hematology - Onocology Associates of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7970 www.southeastmissouri hospital.com
Pyramid Home Care Park Hills, MO P. 573-431-3427
Hugo A. Villarreal, M.D. The Surgery Center of Farmington Farmington, MO P. 573-756-8000 www.thesurgerycenter offarmington.com
Hermatologist / Oncologist James Glauber, MD Jefferson Regional Medical Center Festus , MO P. 636-931-3655 www.jeffersonmemorial.org Pascale Salem, MD Jefferson Regional Medical Center Festus , MO P. 636-931-3655 www.jeffersonmemorial.org Robert Rosser, MD Jefferson Regional Medical Center Festus , MO P. 636-931-3655 www.jeffersonmemorial.org Stephen Janney, MD Jefferson Regional Medical Center Festus , MO P. 636-931-3655 www.jeffersonmemorial.org William Moriconi, MD Jefferson Regional Medical Center Festus , MO P. 314-842-6472 www.jeffersonmemorial.org Robert Oldham, M.D. Hematology - Onocology Associates of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7970 www.southeastmissouri hospital.com Celia Chan. M.D. Hematology - Onocology Associates of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7970 www.southeastmissouri hospital.com
Missouri Home Care Farmington, MO P. 573-760-0751
Private Nursing Farmington, MO P. 573-756-4504
Reliable Home Care Desloge, MO P. 573-431-3427 SE Missouri Home Health Cape Girardeau, MO P. 800-910-4355
Home Health Advantage Nursing Services Farmington, MO P. 573-756-7743
VNA Farmington, MO P. 866-948-8388
American Home Care Park Hills, MO P. 573-431-6599 www.american-homecare.com BJC Home Care Services Farmington, MO P. 573-760-8575
Washington County Hospital Home Health Potosi, MO P. 573-438-7901
Hospice
Covenant Care Services Fredericktown, MO P. 573-783-6256
AmHeart Hospice Farmington, MO P. 877-756-0554 www.callmyhospice.com
Genesis Home Care Farmington, MO P. 573-747-0052
BJC Hospice Farmington, MO P. 573-760-8550
Harden Healthcare Park Hills, MO P. 573-756-7743
HospiceCare Inc Park Hills, MO P. 573-431-0162 www.hospicecare-inc.org
Healthy Home & Family Farmington, MO P. 573-760-8643
Jefferson Regional Hospice Festus, MO P. 800-870-4996 www.jeffersonmemorial.org
Home Care Nursing Farmington, MO P. 573-747-1678
Presbyterian Hospice of MidAmerica Farmington, MO P. 573-756-7066
Jefferson Regional Home Care Festus, MO P. 800-870-4996 Madison Medical Center Home Health Fredericktown, MO P. 573-783-7443
Safe Harbor Farmington, MO P. 573-783-7625 VNA Farmington, MO P. 573-747-1177 www.vnatip.com
RSVP Health | www.rsvphealth.com 77
Health care Providers List
Chands’ Medical Office Family Urgent Care Farmington, MO P. 573-756-7880
Health care Providers List
Hospitals
Infectious Disease
BJC Parkland Bonne Terre St. Francois County, MO P. 573-358-1400 www.parklandhealthcenter.org
Diane Marchesani, D.O. Hematology - Onocology Associates of SE Missouri Hospital Festus, MO P. 636-937-7900
BJC Parkland Farmington St. Francois County, MO P. 573-756-6451 www.parklandhealthcenter.org Ironton County Hospital Iron County, MO P. 573-546-1260 www.ironhospital.com Jefferson Regional Medical Center Jefferson County, MO P. 636-933-1000 www.jeffersonmemorial.org Madison Medical Center Madison County, MO P. 573-783-3341 www.madisonmedicalcenter.net Mineral Area Regional St. Francois County, MO P. 573-756-4581 www.marmc.net Perry County Hospital Perry County, MO P. 573-547-2536 www.pchmo.org SE Missouri Hospital Cape County, MO P. 800-800-5123 www.southeastmissouri hospital.com SSM Cardinal Glennon Hospital St. Louis, MO P. 314-577-5600 www.cardinalglennon.com SSM St Clare Health Center Fenton, MO P. 636-496-2000 www.ssmstclare.com St. Francis Hospital Cape County, MO P. 573-331-3000 www.sfmc.net Ste. Genevieve County Memorial Hospital Ste. Genevieve, MO P. 573-883-2751 www.stegenevievehospital.org Washington County Memorial Hospital Washington County, MO P.573-438-5451 www.wcmhosp.org
Sreenu Ada, M.D. Jefferson Regional Medical Center Festus , MO P. 314-823-3900 www.jeffersonmemorial.org
Medical Equipment
BJC Home Medical Equipment Farmington, MO P. 573-747-1075
Internal Medicine
Sudhirkumar Shah, MD Jefferson Regional Medical Center Festus , MO P. 636-797-2330 www.jeffersonmemorial.org
Ash Patel, MD Jefferson Regional Medical Center Festus , MO P. 636-937-1528 www.jeffersonmemorial.org
Yusuf Chaudhry, MD Jefferson Regional Medical Center Festus , MO P. 636-937-0025 www.jeffersonmemorial.org
Ben Albano, Jr. MD Jefferson Regional Medical Center Festus , MO P. 636-937-8642 www.jeffersonmemorial.org
Raul Borrego, M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org
Diabetes Care Club P. 888-395-6009
Briccio Cadiz, MD Jefferson Regional Medical Center Festus , MO P. 636-937-7903 www.jeffersonmemorial.org
Gary Grix, M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org
Hartley Hearing Aid Services Park Hills, MO P. 573-431-2717
Charles J. Willey, MD Jefferson Regional Medical Center Festus , MO P. 314-843-4794 www.jeffersonmemorial.org
Scott Kirkley M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org
Duk Park, MD Jefferson Regional Medical Center Festus , MO P. 636-937-9322 www.jeffersonmemorial.org
Joanne Waltman, M.D. Jefferson Multi-Specialty Group Festus, MO P. 800-781-0049
Indu Patel, MD Jefferson Regional Medical Center Festus , MO P. 636-464-7032 www.jeffersonmemorial.org Joseph Elterman, MD Jefferson Regional Medical Center Festus , MO P. 636-937-9336 www.jeffersonmemorial.org Kurmanadha Chadalawada, MD Jefferson Regional Medical Center Festus , MO P. 636-461-1414 www.jeffersonmemorial.org Martha Reed, MD Jefferson Regional Medical Center Festus , MO P. 636-586-6820 www.jeffersonmemorial.org Musaddeque Ahmad, M.D. Jefferson Regional Medical Center Festus , MO P. 636-933-6300 www.jeffersonmemorial.org
78 RSVP Health | www.rsvphealth.com
Steven Smith, D.O. Madison Medical Center Fredericktown, MO P. 573-783-4111 www.madisonmedicalcenter.net Martha McGraw Fredericktown, MO P. 573-783-2552 Vilbulakaopun Pairat, M.D. Bonne Terre, MO P. 573-358-5577 John Hartman, D.O. Fredericktown, MO P. 573-756-6438 Laurence Lum, D.O. Quality Healthcare Inc Farmington, MO P. 573-431-4449
Laboratories AIM Laboratories Leadington, MO P. 573-431-8940 www. aimlaboratories.com
Bio Basics Global Park Hills, MO P. 573-431-6664
Clay Medical Supplies Desloge, MO P. 573-431-5183 Darla Queen The Hearing Aid Lady Park Hills, MO P. 573-431-3633
Diabetic Medicare Patients P. 800-308-1208
Healthcare Equipment & Supply Company Perryville, MO P. 573-542-2055 www.healthcarexequip.com Hometown Hearing & Audiology Farmington, MO P. 573-756-5550 Lincare Farmington, MO P. 573-756-7747 Med Supply Park Hills, MO P. 573-431-6660 Medical West Farmington, MO P. 573-747-0008 Miracle Ear Center Farmington, MO P. 573-756-6916 Yon Hearing Instruments Farmington, MO P. 573-756-1919
Mental Health BJC Behavioral Health Services Farmington, MO P. 573-756-5353 Center for Creative Change Farmington, MO P. 573-756-3330
Community Counseling Center Fredericktown, MO P. 573-783-4104 www.cccntr.com Madison County Council for Developmentally Disabled Fredericktown, MO P. 573-783-3770 Mineral Area CPRC Farmington, MO P. 573-756-2899 Mineral Area Program Farmington, MO P. 573-747-0291 Pathways Farmington, MO P. 573-756-6101 SE Missouri Behavorial Health Park Hills MO P. 573-431-3341 Tender Hearts Child Therapy Arcadia Valley, MO P. 573-546-1408
Neurologist Basit Chaudhari, M.D. Neurosciences Center of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7840 www.southeastmissouri hospital.com Aaron Koonce, D.O. Neurosciences Center of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7840 www.southeastmissouri hospital.com
Nursing Homes Americare Ashbrook Farmington, MO P. 573-756-5544 www.americareusa.net Americare Clark’s Mountain Nursing Center Piedmont, MO P. 573-223-4297 www.americareusa.net Americare Parkwood Meadows St. Genevieve, MO P. 573-883-3883 www.americareusa.net
Americare Southbrook Farmington, MO P. 573-756-6658 www.americareusa.net Camelot Farmington, MO P. 573-756-8911 Carriage Manor Farmington, MO P. 573-756-8140 ClaRu DeVille Fredericktown, MO P. 573-783-3993 Colonial Residential Care Facilities Bismarck, MO P. 573-734-2846
St Frances Manor Farmington, MO P. 573-747-1285
Stockoff/Madison Medical Center Fredericktown, MO P. 573-783-3341
Community Manor Farmington, MO P. 573-756-8998
John Grechus, M.D. Ladies First Ob/Gyn Farmington, MO P. 573-756-9013 www.ladiesfirstobgyn.com
Crawford Ranch Boarding Home Farmington, MO P. 573-756-4656 Farmington Manor Farmington, MO P. 573-756-7566
Marion Eye Centers Cape Girardeau, MO P. 877-269-4545 www.marioneyecenters.com
St Joe Manor Bonne Terre, MO P. 573-358-2800
Obstetrics / Gynecologist
Country Meadows Park Hills, MO P. 573-431-2889
Chas Cozean, M.D. Cozean Eye Clinic Cape Girardeau, MO P. 800-456-4401 www.madisonmedicalcenter.net
Presbyterian Manor Farmington, MO P. 573-756-6768
Columbia Street Manor Farmington, MO P. 573-756-7481
Country Haven Boarding Home Farmington, MO P. 573-756-8141
Opthamologist
Potosi Manor Potosi, MO P. 573-438-3225
John Fitz, M.D. Precision Eye Care Inc Farmington, MO P. 573-756-2020 www.myprecisioneyecare.com Premiere Eye Associates Festus, MO P. 636-937-8855 www.premiereeye.com
Scott Synder, M.D. Farmington, MO P. 573-756-2180 www.drscottsnyder.com
Optometrist Brost & Strohmeyer Family Eye Care Fredericktown, MO P. 573-783-2251
George Gasser, D.O. Farmington, MO P. 573-701-9604
Kinch Jones, O.D. Complete Vision Care Park Hills, MO P. 573-431-1301 www.completevisioncaremo.com
Shelley Lee, D.O. Farmington, MO P. 573-756-0888
Georgian Gardens Potosi, MO P. 573-438-6261
Occupational Medicine
Harris Manor Farmington, MO P. 573-756-5376
Donn Richards, M.D. Jefferson Regional Occupational Medicine Festus, MO www.jeffersonregional.com
L & J Residential Care Facility Farmington, MO P. 573-756-3047 New Hope Park Hills, MO P. 573-431-7336 NHC Desloge, MO P. 573-431-0223 Ozark Manor Fredericktown, MO P. 573-783-8338 www.ozarkmanoralf.com Ozark Manor Care Center Fredericktown, MO P. 573-783-6333
Anton Beffa, M.D. Precision Eye Care Inc Farmington, MO P. 573-756-2020 www.myprecisioneyecare.com
Frank Krewett, M.D. Jefferson Regional Occupational Medicine Festus, MO P. 636-933-1669 www.jeffersonregional.com Matthew Karshner, M.D. Occupatinal Medicine Clinic of SE Missouri Hospital Cape Girardeau, MO P. 573-986-4404 www.southeastmissouri hospital.com
Evan Williams, O.D. Complete Vision Care Park Hills, MO P. 573-431-1301 www.completevisioncaremo.com Christopher Brenon, O.D. Complete Vision Care Park Hills, MO P. 573-431-1301 www.completevisioncaremo.com Mark Kahrhoff, O.D. Complete Vision Care Park Hills, MO P. 573-431-1301 www.completevisioncaremo.com Specs Optical Desloge, MO P. 573-518-0001 www.specsopticalonline.com Shelton Sago, O.D. Sago & Street Eyecare Farmington, MO P. 573-756-3170
RSVP Health | www.rsvphealth.com 79
Health care Providers List
Childrens Haven Farmington, MO P. 573-756-2108
Health care Providers List
Bob Lype, O.D. Heartland Eyecare Farmington, MO P. 573-760-1300 Jason Street, O.D. Sago & Street Eyecare Farmington, MO P. 573-756-3170 Michelle Spray, O.D. Mueller & Spray Optometry Bonne Terre, MO P. 573-358-4148
Orthodontist Sid Herr Herr Orthodontists Festus, MO P. 636-296-6332 www.HerrOrtho.com Edmund Yepez Festus, MO P. 636-931-5888 Rodney Rhodes Farmington, MO P. 573-756-5600 Kevin Walsh Farmington, MO P. 573-756-5756
Orthopedic Surgery Craig Ruble, MD Jefferson Regional Medical Center Festus , MO P. 636-933-7400 www.jeffersonmemorial.org Paul Maynard, MD Jefferson Regional Medical Center Festus , MO P. 636-933-7400 www.jeffersonmemorial.org Robert R. Smeyne, D.O. Jefferson Regional Medical Center Festus , MO P. 636-933-7400 www.jeffersonmemorial.org Carence Temple, M.D. Jefferson Orthopaedic Associates Festus, MO P. 800-582-1143 William Kennen, D.O. Jefferson Orthopaedic Associates Festus, MO P. 800-582-1143 James Burke, M.D. Orthopedic Associates Fredericktown, MO P. 314-569-0612 www.oastl.com
Richard Hulsey, MD James Burke, M.D. Orthopedic Associates Bonne Terre, MO P. 314-569-0612 www.oastl.com Victor Brown, D.O. Farmington, MO P. 573-756-4581 Scott Vanness, D.O. Midwest Orthopedic Center Farmington, MO P. 573-756-7779
Pediatrition Darlene Moore, M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org Sujatha Ayyagari, M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org Jeanne Kornhardt, M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org Crystal City Pediatrics Farmington, MO P. 573-756-4343 www.ccpeds.com Daniel Beaver, M.D. Neonatology Services of SE Missouri Hospital Cape Girardeau, MO P. 573-334-4822 www.southeastmissouri hospital.com Michelle Lewis Neonatology Services of SE Missouri Hospital Cape Girardeau, MO P. 573-334-4822 www.southeastmissouri hospital.com Jamal Zereilk, M.D. Farmington, MO P. 573-454-2410
Pharmaceutical Austin Plaza Pharmacy Potosi, MO P. 573-438-2349 Country Mart Pharmacy Bonne Terre, MO P. 573-358-0099
80 RSVP Health | www.rsvphealth.com
Country Mart Pharmacy Park Hills, MO P. 573-431-8537 Dicus Prescription Drugs Fredericktown, MO P. 573-783-2788 Dicus Prescription Drugs Farmington, MO P. 573-756-5425 Good Neighbor Pharmacy P. 888-467-7867 Medicap Farmington, MO P. 573-760-0200 www.medicap.com Medicap Park Hills, MO P. 573-431-4133 www.medicap.com Medi-Care Plus Pharmacy Farmington, MO P. 573-756-8906 Medicate Fredericktown, MO P. 573-783-5508 Medicine Shoppe Potosi, MO P. 573-438-2189 www.medicineshoppe.com Parkland Health Mart Pharmacy Desloge, MO P. 573-431-6677 www.healthmart.com Pharmax Bonne Terre, MO P. 573-358-3301 www.pharmax-rx.com USA Drug Bonne Terre, MO P. 573-358-3311 www.usadrugmissouri.com USA Drug Farmington, MO P. 573-756-6421 www.usadrugmissouri.com USA Drug Desloge, MO P. 573-431-2242 www.usadrugmissouri.com USA Drug Ironton, MO P. 573-546-7915 www.usadrugmissouri.com Walgreens Farmington, MO P. 800-925-4733 www.walgreens.com
Walmart Pharmacy Desloge, MO P. 573-431-5094 www.walmart.com Walmart Pharmacy Farmington, MO P. 573-756-8448 www.walmart.com Wellfount Farmington, MO P. 573-747-0860 www.wellfount.com
Physical Therapy BJC Parkland Therapy Services Farmington, MO P. 573-756-4574 Farmington Hand & Physical Therapy Inc Farmington, MO P. 573-756-2320 www.farmingtonpt.com Farmington Sports & Rehab Center Farmington, MO P. 573-756-2999 www.farmingtonsports andrehab.com Jefferson Regional Rehab Center Festus, MO P. 636-933-1606 Madison Medical Physical Therapy Fredericktown, MO P. 573-783-1092 www.madisonmedicalcenter.net MARMC Physical Therapy & Occupational Therapy Farmington, MO P. 573-701-7237 Midwest Orthopedic Center Farmington, MO P. 573-756-3400 Pro Rehab Farmington, MO P. 573-756-9900 www.prorehabpc.com
Podiatrist Christopher Sloan, DPM Desloge Foot and Ankle Desloge, MO P. 573-431-1595 Midwest Podiatry & Associates Farmington, MO P. 573-756-8986
Surgeon
Thomas Nowotny, M.D. Community Counseling Center Cape Girardeau, MO P. 573-334-1100 www.cccntr.com
Daniel Cox, MD Jefferson Regional Medical Center Festus , MO P. 636-931-4002 www.jeffersonmemorial.org
Shajitha Nawaz, M.D. Community Counseling Center Cape Girardeau, MO P. 573-334-1100 www.cccntr.com
Gregg Ginsburg, MD Jefferson Regional Medical Center Festus , MO P. 636-931-4744 www.jeffersonmemorial.org
Manisha Lele, M.D. Community Counseling Center Cape Girardeau, MO P. 573-334-1100 www.cccntr.com
Kenneth G. Smith, MD Jefferson Regional Medical Center Festus , MO P. 314-842-6183 www.jeffersonmemorial.org
Mittal Vikrant, M.D. Farmington, MO P. 573-756-6751
Michael A. Smith, MD Jefferson Regional Medical Center Festus , MO P. 314-842-6183 www.jeffersonmemorial.org
Pulmonologist Musa Wadi, M.D. Pulmonary Clinic of SE Missouri Hospital Cape Girardeau, MO P. 573-331-7830 www.southeastmissouri hospital.com Joseph Ojile, M.D. Clayton Sleep Institute Maplewood, MO P. 314-645-5855 www.claytonsleepinstitute.com
Radiologist Alliance Imaging Farmington, MO P. 573-760-0453 Midwest Imaging Center Farmington, MO P. 573-760-1674 Open MRI of Washington County Potosi, MO P. 800-891-4894
Rheumatologist Maria Vintimilla M.D. Family Urgent Care Farmington, MO P. 573-756-2482 Hamid Bashir, MD Jefferson Multi-Specialty Group Fredericktown, MO P. 800-781-0049
Steven Kurzweil, MD Jefferson Regional Medical Center Festus , MO P. 636-937-6601 www.jeffersonmemorial.org
Kevin Enger, MD Jefferson Regional Medical Center Festus , MO P. 636-931-5080 www.jeffersonmemorial.org Ryan T. Miller, MD Jefferson Regional Medical Center Festus , MO P. 636-931-5080 www.jeffersonmemorial.org Erik Houttuin, M.D. Modern Urology, Inc Festus, MO P. 636-937-8883 Frederick Walters, M.D. Modern Urology, Inc Festus, MO P. 636-937-8883
Wound Care Lawrence Billy, M.D. Jefferson Multi-Specilaty Group Festus , MO P. 800-781-0049 www.jeffersonmemorial.org
Teresa Cavins, M.D. Jefferson Multi-Specialty Group Festus , MO P. 800-781-0049 www.jeffersonmemorial.org Travis Methvin, MD Jefferson Regional Medical Center Festus , MO P. 636-931-4913 www.jeffersonmemorial.org Jeffrey Swinarski, M.D. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org Brain Gallagher, D.O. BJC Parkland/Medical Arts Clinic Farmington, MO P. 573-756-6751 www.parklandhealthcenter.org Mark Vasko, M.D. Madison Medical Center Fredericktown, MO P. 573-783-4111 www.madisonmedicalcenter.net
Urologist Carlos Deleste, MD Jefferson Regional Medical Center Festus , MO P. 636-937-8118 www.jeffersonmemorial.org
RSVP Health | www.rsvphealth.com 81
Health care Providers List
Psychiatrist
Continuity of Care and You | By John Grechus, M.D., Dr. Rodney D. Gross Ph.D.,
For over twenty years, I have built a relationship with you, the communities I serve and the health care entities where I perform my services. I have prided myself in always keeping you foremost in mind when managing your health and wellness. Now I have the opportunity to expand on these relationships and encompass the true definition of Continuity of Care both professionally and personally.
John Grechus, M.D. Ladies First OB/GYN
Let us talk about the professional definition of Continuity of Care. The one I like is from the American Academy of Family Physicians: Continuity of care is the process by which the patient and the physician are cooperatively involved in ongoing health care management toward the goal of high quality, cost-effective medical care.
Continuity of care is facilitated by a physicianled, team-based approach to health care. Continuity of care is a hallmark and primary objective of medicine and is consistent with quality patient care. The continuity of care inherent in medicine helps physicians gain their patients’ confidence and enables physicians to be more effective patient advocates. It also facilitates the physician’s role as a cost-effective coordinator of the patient’s health services by making early recognition of problems possible. Continuity of care is rooted in a long-term patient-physician partnership in which the physician knows the patient’s history from experience and can integrate new information and decisions from a whole-patient perspec-
82 RSVP Health | www.rsvphealth.com
tive efficiently without extensive investigation or record review. Continuity of care is facilitated by a physicianled, team-based approach to health care. My personal feeling is defined by my own actions, work ethic and professionalism, which I have brought to you through my practice from the very first day. This leads me to the expansion of these said actions, which I am proud to announce. This late summer and fall, I will be relocating my office, still under my ownership, to the campus of Mineral Area Regional Medical Center. I will still offer my practice’s services at both local hospitals in Farmington. In choosing the location, I made the decision based off the needs of you, the patient. This allows greater accessibility, expanded office design and more room to add services, technology, and staff all with making your health and wellness experience with us the best it can be. On the staff, I am proud to introduce Danielle Carron, M.D. to our practice. She has embraced my overall vision of “whole care” for our communities we serve. In addition, with her and our other staff, we are truly expanding and enhancing “Continuity of Care” for you. You have been accustomed to my practice and I maintaining your care through female services, including pregnancy and gynecology. Now with the new location and staff addition, our vision has shifted to add to your experience and further the trust we have developed by offering enhanced Family Practice and Pediatric care. Following you through your pregnancy is our pleasure and now with the trust, we have built together; our office will now offer the same dedication with you and your child after birth. Remembering the true Continuity of Care, you will not have to leave our trusted services. Records, Family History, Familiarity, Comfort and Trust continue without any transfers or new searches. The faces stay familiar along with the friendships.
84 RSVP Health | www.rsvphealth.com